Pub Date : 2024-10-05DOI: 10.1016/j.arcmed.2024.103091
Alfredo Ulloa-Aguirre , Regina Llamosas , James A. Dias
Follicle-stimulating hormone (FSH), or follitropin, exists in multiple molecular forms due largely to its protein-carbohydrate composition and the complexity of the glycans attached to the protein core. The heterogeneity of gonadotropins exists in two forms, macroheterogeneity, which results from the absence of one or two oligosaccharide chains in the ß-subunit, and microheterogeneity which results from variation in the structures and complexity of the glycans attached to the hormone. In the clinical arena, FSH compounds are widely used by fertility specialists to promote ovarian follicle growth and maturation to a preovulatory follicle containing a fertilization-competent oocyte. Several genetically engineered recombinant human FSH preparations have been added to the arsenal of follitropin preparations in several countries for the treatment of infertility, particularly in women attending assisted reproduction clinics. Although the primary structure of these recombinant proteins is identical to that of naturally occurring FSH, the cell context and variations in the production and purification processes may impact the glycosidic profile of the recombinant FSH macro- and micro-heterogeneity, which may potentially influence the pharmacokinetics and pharmacodynamics of the compound. This review concentrates on the structure-function correlates of follitropin, with emphasis on the physiological and biological importance of the carbohydrates attached to its protein core, including its pharmacokinetics and biological activity. Emphasis is placed on pituitary FSH, and the available data on the various recombinant FSH preparations employed in therapeutics are also discussed, considering that this gonadotropin represents the cornerstone for the treatment of infertility in modern assisted reproduction.
{"title":"Follicle-stimulating hormone sweetness: How carbohydrate structures impact on the biological function of the hormone","authors":"Alfredo Ulloa-Aguirre , Regina Llamosas , James A. Dias","doi":"10.1016/j.arcmed.2024.103091","DOIUrl":"10.1016/j.arcmed.2024.103091","url":null,"abstract":"<div><div>Follicle-stimulating hormone (FSH), or follitropin, exists in multiple molecular forms due largely to its protein-carbohydrate composition and the complexity of the glycans attached to the protein core. The heterogeneity of gonadotropins exists in two forms, macroheterogeneity, which results from the absence of one or two oligosaccharide chains in the ß-subunit, and microheterogeneity which results from variation in the structures and complexity of the glycans attached to the hormone. In the clinical arena, FSH compounds are widely used by fertility specialists to promote ovarian follicle growth and maturation to a preovulatory follicle containing a fertilization-competent oocyte. Several genetically engineered recombinant human FSH preparations have been added to the arsenal of follitropin preparations in several countries for the treatment of infertility, particularly in women attending assisted reproduction clinics. Although the primary structure of these recombinant proteins is identical to that of naturally occurring FSH, the cell context and variations in the production and purification processes may impact the glycosidic profile of the recombinant FSH macro- and micro-heterogeneity, which may potentially influence the pharmacokinetics and pharmacodynamics of the compound. This review concentrates on the structure-function correlates of follitropin, with emphasis on the physiological and biological importance of the carbohydrates attached to its protein core, including its pharmacokinetics and biological activity. Emphasis is placed on pituitary FSH, and the available data on the various recombinant FSH preparations employed in therapeutics are also discussed, considering that this gonadotropin represents the cornerstone for the treatment of infertility in modern assisted reproduction.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"55 8","pages":"Article 103091"},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.arcmed.2024.103088
Hinpetch Daungsupawong , Viroj Wiwanitkit
{"title":"Comment on “Serendipitous adrenal hyperplasia in patients admitted to the emergency department for suspected SARS-CoV-2 infection is linked to increased mortality”","authors":"Hinpetch Daungsupawong , Viroj Wiwanitkit","doi":"10.1016/j.arcmed.2024.103088","DOIUrl":"10.1016/j.arcmed.2024.103088","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103088"},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.arcmed.2024.103093
Andrea Alcaraz, Emiliano Navarro, Verónica Alfie, Lucas Perelli, Sebastián García Martí, Agustín Ciapponi, Ariel Bardach, Andrés Pichon-Riviere, Federico Augustovski
Introduction
Health technology assessment (HTA) is a standardized methodology that allows the assessment technologies’ value. By incorporating the perspective of stakeholders in a public consultation process, transparency and quality of decisions can be improved.
Objective
To describe the active stakeholder consultation process for rapid HTAs in an Argentinean, independent, academic, non-profit HTA agency, assessing its initial five years.
Methods
Since 2017, we have been conducting an active public consultation process for rapid HTA documents, inviting producers, healthcare professionals, and patient organizations to provide comments, and their input may lead to changes in the HTA documents. Changes were classified as major (changes to the coverage recommendation), intermediate (changes in efficacy, net benefit, or cost-effectiveness that did not change coverage recommendations), and minor modifications (other changes).
Results
From May 2017–August 2022, 308 rapid HTA (rHTA) reports were published, and 3,438 invitations were sent. 140 rHTA (45.5%) received a total of 228 comments. Comments came from producers in 53% (n = 112) and healthcare professional organizations in 31.2% (n = 66). Technologies evaluated were drugs in 37% (n = 114), procedures in 35.5% (n = 109), diagnostic methods in 15.3% (n = 47), and devices in 12.2% (n = 38). Out of 308 rHTA documents, 120 (39%) were modified—mostly minor adjustments (n = 100; 80%), followed by major (n = 12; 10%) and intermediate modifications (n = 8; 6.4%).
Conclusion
Implementing an active stakeholder involvement process in HTA is feasible in a low- to middle-income country context and strengthens and improves the HTA process.
{"title":"Design and implementation of a stakeholder consultation process for rapid health technology assessments in Argentina","authors":"Andrea Alcaraz, Emiliano Navarro, Verónica Alfie, Lucas Perelli, Sebastián García Martí, Agustín Ciapponi, Ariel Bardach, Andrés Pichon-Riviere, Federico Augustovski","doi":"10.1016/j.arcmed.2024.103093","DOIUrl":"10.1016/j.arcmed.2024.103093","url":null,"abstract":"<div><h3>Introduction</h3><div>Health technology assessment (HTA) is a standardized methodology that allows the assessment technologies’ value. By incorporating the perspective of stakeholders in a public consultation process, transparency and quality of decisions can be improved.</div></div><div><h3>Objective</h3><div>To describe the active stakeholder consultation process for rapid HTAs in an Argentinean, independent, academic, non-profit HTA agency, assessing its initial five years.</div></div><div><h3>Methods</h3><div>Since 2017, we have been conducting an active public consultation process for rapid HTA documents, inviting producers, healthcare professionals, and patient organizations to provide comments, and their input may lead to changes in the HTA documents. Changes were classified as major (changes to the coverage recommendation), intermediate (changes in efficacy, net benefit, or cost-effectiveness that did not change coverage recommendations), and minor modifications (other changes).</div></div><div><h3>Results</h3><div>From May 2017–August 2022, 308 rapid HTA (rHTA) reports were published, and 3,438 invitations were sent. 140 rHTA (45.5%) received a total of 228 comments. Comments came from producers in 53% (<em>n</em> = 112) and healthcare professional organizations in 31.2% (<em>n</em> = 66). Technologies evaluated were drugs in 37% (<em>n</em> = 114), procedures in 35.5% (<em>n</em> = 109), diagnostic methods in 15.3% (<em>n</em> = 47), and devices in 12.2% (<em>n</em> = 38). Out of 308 rHTA documents, 120 (39%) were modified—mostly minor adjustments (<em>n</em> = 100; 80%), followed by major (<em>n</em> = 12; 10%) and intermediate modifications (<em>n</em> = 8; 6.4%).</div></div><div><h3>Conclusion</h3><div>Implementing an active stakeholder involvement process in HTA is feasible in a low- to middle-income country context and strengthens and improves the HTA process.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103093"},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.arcmed.2024.103087
Jesús Medina-Ranilla , Hannah H. Leslie , Javier Roberti , Laura Espinoza-Pajuelo , Marina Guglielmino , Agustina Mazzoni , Ezequiel García-Elorrio , Patricia J. García
Background and aims
Healthcare provision to distinct social groups in Latin America contributes to inequities. Individuals make active choices by bypassing their coverage and intended healthcare source. After the pandemic, we sought to characterize bypassing behaviors and quantify their effects on access to essential services.
Methods
Cross-sectional data from a population-based telephone survey in Peru and Uruguay were analyzed. Participants were selected by random digit dialing. Outcomes were defined as access to preventive screenings and satisfaction of emerging health needs. Bypassing by level was defined as when participants went around primary care for the usual source of care or last preventive visit; bypassing by coverage when care was sought outside of public coverage or social security. Sociodemographic characteristics were included, and the adjusted average treatment effect was calculated.
Results
Data from 1,255 participants in Peru and 1,237 participants in Uruguay were analyzed. Bypassing behaviors by level (32% Peru; 60% Uruguay) and coverage (29% Peru; 21% Uruguay) were more prevalent in more privileged groups, especially in Peru. System competence was low overall and varied by bypassing mode, especially in Peru. In the adjusted analysis, statistically significant differences were found in bypassing by coverage in Peru (–8% difference in unmet health needs) and by level in Uruguay (5% more unmet needs).
Conclusion
Provision of essential preventive services was insufficient in both countries. In Peru, bypassing could serve as a proxy measure of inequities. Reminders of preventive services could be offered to bypassers of primary care. Profound health system reforms are needed to ensure equitable access to essential services.
{"title":"Bypassing sources of care by level and coverage: Access to essential services in Peru and Uruguay in the post-pandemic era","authors":"Jesús Medina-Ranilla , Hannah H. Leslie , Javier Roberti , Laura Espinoza-Pajuelo , Marina Guglielmino , Agustina Mazzoni , Ezequiel García-Elorrio , Patricia J. García","doi":"10.1016/j.arcmed.2024.103087","DOIUrl":"10.1016/j.arcmed.2024.103087","url":null,"abstract":"<div><h3>Background and aims</h3><div>Healthcare provision to distinct social groups in Latin America contributes to inequities. Individuals make active choices by bypassing their coverage and intended healthcare source. After the pandemic, we sought to characterize bypassing behaviors and quantify their effects on access to essential services.</div></div><div><h3>Methods</h3><div>Cross-sectional data from a population-based telephone survey in Peru and Uruguay were analyzed. Participants were selected by random digit dialing. Outcomes were defined as access to preventive screenings and satisfaction of emerging health needs. Bypassing by level was defined as when participants went around primary care for the usual source of care or last preventive visit; bypassing by coverage when care was sought outside of public coverage or social security. Sociodemographic characteristics were included, and the adjusted average treatment effect was calculated.</div></div><div><h3>Results</h3><div>Data from 1,255 participants in Peru and 1,237 participants in Uruguay were analyzed. Bypassing behaviors by level (32% Peru; 60% Uruguay) and coverage (29% Peru; 21% Uruguay) were more prevalent in more privileged groups, especially in Peru. System competence was low overall and varied by bypassing mode, especially in Peru. In the adjusted analysis, statistically significant differences were found in bypassing by coverage in Peru (–8% difference in unmet health needs) and by level in Uruguay (5% more unmet needs).</div></div><div><h3>Conclusion</h3><div>Provision of essential preventive services was insufficient in both countries. In Peru, bypassing could serve as a proxy measure of inequities. Reminders of preventive services could be offered to bypassers of primary care. Profound health system reforms are needed to ensure equitable access to essential services.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103087"},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1016/j.arcmed.2024.103092
Isabel Ochando , Antonio Urbano , Joaquín Rueda
Thanks to advances in technology, genetic testing is now available to explore the causes of infertility and to assess the risk of a given couple passing on a genetic disorder to their offspring. This allows at-risk couples to make an informed decision when opting for assisted reproduction and allows professionals to offer pre-implantation diagnosis when appropriate. Genetic screening of an infertile couple has thus become standard practice for an appropriate diagnosis, treatment, and prognostic assessment. This review aims to highlight the conditions under which genetic screening plays a role in improving reproductive outcomes for infertile couples.
{"title":"Genetics in reproductive medicine","authors":"Isabel Ochando , Antonio Urbano , Joaquín Rueda","doi":"10.1016/j.arcmed.2024.103092","DOIUrl":"10.1016/j.arcmed.2024.103092","url":null,"abstract":"<div><div>Thanks to advances in technology, genetic testing is now available to explore the causes of infertility and to assess the risk of a given couple passing on a genetic disorder to their offspring. This allows at-risk couples to make an informed decision when opting for assisted reproduction and allows professionals to offer pre-implantation diagnosis when appropriate. Genetic screening of an infertile couple has thus become standard practice for an appropriate diagnosis, treatment, and prognostic assessment. This review aims to highlight the conditions under which genetic screening plays a role in improving reproductive outcomes for infertile couples.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"55 8","pages":"Article 103092"},"PeriodicalIF":4.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1016/j.arcmed.2024.103089
Giuseppe Reimondo, Soraya Puglisi, Massimo Terzolo
{"title":"Response to: Serendipitous adrenal hyperplasia in patients admitted to the emergency department is linked to increased mortality","authors":"Giuseppe Reimondo, Soraya Puglisi, Massimo Terzolo","doi":"10.1016/j.arcmed.2024.103089","DOIUrl":"10.1016/j.arcmed.2024.103089","url":null,"abstract":"","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103089"},"PeriodicalIF":4.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Five hundred and forty-five participants were enrolled, most from Argentina and Mexico. The overall quality of the intervention scored 19.62/20 points, obtaining 4.86/5 points for applicability. There were no significant differences between virtual and face-to-face sessions.
After the intervention, ≥93.76% of participants felt able to engage in clinical debriefing, and 97.06% reported willingness to debrief.
Conclusions
Dissemination of multi-professional clinical debriefing training in Latin America is feasible and easily scalable. The quality of the educational intervention was rated excellent in both virtual and face-to-face settings, supporting the value of remote educational diffusion. Most participants in this study intervention felt prepared and willing to debrief following the intervention.
Pub Date : 2024-09-26DOI: 10.1016/j.arcmed.2024.103084
Elainne Silva Freire , Letícia Pinto da Silva , Aline do Carmo Silva , Pedro Alves Soares Vaz de Castro , Giovanna Rotondo de Araújo , Dayane Andriotti Otta , Danilo Cavalcante Braz , Juliana Maria Trindade Bezerra
Chagas disease (CD) is a parasitic infection caused by the protozoan Trypanosoma cruzi (Kinetoplastida, Trypanosomatidae). Benznidazole (Bz) has a limited ability to interfere with the pathogenicity of the parasite, which manages to overcome host defenses. This study aimed to conduct a systematic literature review and meta-analysis to understand and describe the drugs and their combinations, as well as new promising compounds used in the treatment of CD in Brazil. This study was registered in the Open Science Framework (OSF) and the International Prospective Register of Systematic Reviews, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the electronic scientific databases PubMed, LILACS, SciELO, and BVS. Searches were conducted using descriptors cataloged in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), in Portuguese, English, and Spanish. Of the 26 articles included in this systematic review and meta-analysis, 16 were related to drug combinations, and nine described new inhibitors of parasitic molecules. Despite high heterogeneity (I² = 92%), studies that evaluated the combination of Bz with other treatments for CD had an overall grouped cure rate of 74% (95% CI 54–94%). Only one study presented drug repositioning by monotherapy. Thus, drug combinations offer quick and accessible solutions for CD treatment, acting against resistant strains of T. cruzi. Certainly, the introduction of these promising compounds into the pharmaceutical market is distant, and the adoption of prophylactic measures is recommended as a barrier to the increasing number of CD cases.
南美锥虫病(CD)是由原生动物克鲁斯锥虫(Kinetoplastida,Trypanosomatidae)引起的寄生虫感染。苯并咪唑(Bz)干扰寄生虫致病性的能力有限,而寄生虫却能克服宿主的防御能力。本研究旨在进行系统的文献综述和荟萃分析,以了解和描述巴西用于治疗 CD 的药物及其组合,以及有前景的新化合物。本研究遵循系统综述和荟萃分析首选报告项目(PRISMA)指南,在开放科学框架(OSF)和国际系统综述前瞻性登记处进行了登记。在电子科学数据库 PubMed、LILACS、SciELO 和 BVS 中进行了检索。检索时使用了葡萄牙语、英语和西班牙语的健康科学描述符(DeCS)和医学主题词表(MeSH)中的描述符。在纳入本系统综述和荟萃分析的 26 篇文章中,16 篇与药物组合有关,9 篇描述了寄生虫分子的新抑制剂。尽管异质性很高(I² = 92%),但对 Bz 与其他 CD 治疗方法联合使用进行评估的研究显示,总体分组治愈率为 74%(95% CI 54-94%)。只有一项研究介绍了通过单一疗法重新定位药物的情况。因此,联合用药为 CD 的治疗提供了快速、便捷的解决方案,并能对抗耐药的 T. cruzi 菌株。当然,将这些前景广阔的化合物引入医药市场还很遥远,建议采取预防措施,以阻止 CD 病例的增加。
{"title":"New Drugs and Promising Drug Combinations in the Treatment of Chagas Disease in Brazil: A Systematic Review and Meta-Analysis","authors":"Elainne Silva Freire , Letícia Pinto da Silva , Aline do Carmo Silva , Pedro Alves Soares Vaz de Castro , Giovanna Rotondo de Araújo , Dayane Andriotti Otta , Danilo Cavalcante Braz , Juliana Maria Trindade Bezerra","doi":"10.1016/j.arcmed.2024.103084","DOIUrl":"10.1016/j.arcmed.2024.103084","url":null,"abstract":"<div><div>Chagas disease (CD) is a parasitic infection caused by the protozoan <em>Trypanosoma cruzi</em> (Kinetoplastida, Trypanosomatidae). Benznidazole (Bz) has a limited ability to interfere with the pathogenicity of the parasite, which manages to overcome host defenses. This study aimed to conduct a systematic literature review and meta-analysis to understand and describe the drugs and their combinations, as well as new promising compounds used in the treatment of CD in Brazil. This study was registered in the Open Science Framework (OSF) and the International Prospective Register of Systematic Reviews, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the electronic scientific databases PubMed, LILACS, SciELO, and BVS. Searches were conducted using descriptors cataloged in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), in Portuguese, English, and Spanish. Of the 26 articles included in this systematic review and meta-analysis, 16 were related to drug combinations, and nine described new inhibitors of parasitic molecules. Despite high heterogeneity (<em>I</em>² = 92%), studies that evaluated the combination of Bz with other treatments for CD had an overall grouped cure rate of 74% (95% CI 54–94%). Only one study presented drug repositioning by monotherapy. Thus, drug combinations offer quick and accessible solutions for CD treatment, acting against resistant strains of <em>T. cruzi</em>. Certainly, the introduction of these promising compounds into the pharmaceutical market is distant, and the adoption of prophylactic measures is recommended as a barrier to the increasing number of CD cases.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103084"},"PeriodicalIF":4.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1016/j.arcmed.2024.103086
Ying Xu , Haoyu Huang , Mengyuan Wu , Zesen Zhuang , Hong Liu , Meijin Hou , Cong Chen
Background and aims
As global demographics shift toward an older population, cognitive impairment is becoming increasingly critical. Transcranial Direct Current Stimulation (tDCS), an innovative brain stimulation technique, has the potential to significantly improve cognitive function. Our main aim is to comprehensively analyze the existing literature, identify key aspects of tDCS research in the rehabilitation of cognitive impairment, and predict future trends in this field.
Methods
We used the Web of Science (WOS) database to search for English articles and reviews relevant to this topic. For visual analysis of the literature, we employed the WOS analysis tool, CiteSpace, along with VOSviewer software to ensure comprehensive analysis.
Results
We included 2940 articles published between 1998 and 2023. Over 25 years, annual publications and citations in this field increased steadily, peaking at 379 articles in 2021. Michael A. Nitsche was a major contributor. Most articles came from developed countries, primarily North America and Europe, and journals generally had modest impact factors. Research in this field primarily aims to treat cognitive impairment resulting from pathological aging or neuropsychiatric disorders, with a particular focus on specific brain regions. Recently, researchers have integrated various treatment modalities with tDCS techniques to actively investigate effective strategies to mitigate cognitive impairments associated with pathological aging.
Conclusion
This study presents the first bibliometric analysis of the literature on tDCS in the rehabilitation of cognitive impairment, highlighting key areas of research and emerging trends. These findings provide critical insights for future tDCS interventions targeting cognitive impairment associated with pathological aging.
{"title":"Transcranial Direct Current Stimulation for Cognitive Impairment Rehabilitation: A Bibliometric Analysis","authors":"Ying Xu , Haoyu Huang , Mengyuan Wu , Zesen Zhuang , Hong Liu , Meijin Hou , Cong Chen","doi":"10.1016/j.arcmed.2024.103086","DOIUrl":"10.1016/j.arcmed.2024.103086","url":null,"abstract":"<div><h3>Background and aims</h3><div>As global demographics shift toward an older population, cognitive impairment is becoming increasingly critical. Transcranial Direct Current Stimulation (tDCS), an innovative brain stimulation technique, has the potential to significantly improve cognitive function. Our main aim is to comprehensively analyze the existing literature, identify key aspects of tDCS research in the rehabilitation of cognitive impairment, and predict future trends in this field.</div></div><div><h3>Methods</h3><div>We used the Web of Science (WOS) database to search for English articles and reviews relevant to this topic. For visual analysis of the literature, we employed the WOS analysis tool, CiteSpace, along with VOSviewer software to ensure comprehensive analysis.</div></div><div><h3>Results</h3><div>We included 2940 articles published between 1998 and 2023. Over 25 years, annual publications and citations in this field increased steadily, peaking at 379 articles in 2021. Michael A. Nitsche was a major contributor. Most articles came from developed countries, primarily North America and Europe, and journals generally had modest impact factors. Research in this field primarily aims to treat cognitive impairment resulting from pathological aging or neuropsychiatric disorders, with a particular focus on specific brain regions. Recently, researchers have integrated various treatment modalities with tDCS techniques to actively investigate effective strategies to mitigate cognitive impairments associated with pathological aging.</div></div><div><h3>Conclusion</h3><div>This study presents the first bibliometric analysis of the literature on tDCS in the rehabilitation of cognitive impairment, highlighting key areas of research and emerging trends. These findings provide critical insights for future tDCS interventions targeting cognitive impairment associated with pathological aging.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103086"},"PeriodicalIF":4.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hereditary transthyretin cardiac amyloidosis (ATTRv-CA) after liver transplantation remains challenging to treat due to residual amyloid deposits in extrahepatic organs, including the heart. Tafamidis, a transthyretin tetramer stabilizer, has shown promise in the treatment of ATTRv-CA; however, its efficacy and safety after liver transplantation are uncertain. In this preliminary retrospective review, we assessed the efficacy and safety of tafamidis (80 mg) in three ATTRv-CA cases after liver transplantation. Following one year of treatment, all patients experienced improvement in dyspnea, New York Heart Association functional class, brain natriuretic peptide levels, and cardiac troponin T levels. No significant changes in echocardiographic parameters were observed. Notably, no cardiovascular or drug-related adverse events occurred during treatment. Our findings suggest that tafamidis may benefit post-liver transplant patients with ATTRv-CA and warrant further investigation through randomized controlled trials with larger cohorts. This study highlights a potential therapeutic avenue for the management of cardiovascular involvement in this challenging patient population.
肝移植后的遗传性转甲状腺素心脏淀粉样变性(ATTRv-CA)由于在包括心脏在内的肝外器官中残留淀粉样蛋白沉积物,其治疗仍具有挑战性。Tafamidis是一种转甲状腺素四聚体稳定剂,已显示出治疗ATTRv-CA的前景;然而,其在肝移植后的疗效和安全性尚不确定。在这项初步回顾性研究中,我们评估了他法米迪(80 毫克)在三例 ATTRv-CA 肝移植后的疗效和安全性。治疗一年后,所有患者的呼吸困难、纽约心脏协会功能分级、脑钠肽水平和心肌肌钙蛋白 T 水平均有所改善。超声心动图参数未见明显变化。值得注意的是,治疗期间未发生心血管或药物相关不良事件。我们的研究结果表明,他法米迪可能对肝移植后的 ATTRv-CA 患者有益,值得通过更大规模的随机对照试验进行进一步研究。这项研究为治疗这一具有挑战性的患者群体的心血管疾病提供了一条潜在的治疗途径。
{"title":"Preliminary efficacy and safety analysis of tafamidis in post-liver transplant patients with hereditary transthyretin cardiac amyloidosis","authors":"Takahiro Okumura, Kenji Furusawa, Ryota Ito, Hiroaki Hiraiwa, Toyoaki Murohara","doi":"10.1016/j.arcmed.2024.103083","DOIUrl":"10.1016/j.arcmed.2024.103083","url":null,"abstract":"<div><p>Hereditary transthyretin cardiac amyloidosis (ATTRv-CA) after liver transplantation remains challenging to treat due to residual amyloid deposits in extrahepatic organs, including the heart. Tafamidis, a transthyretin tetramer stabilizer, has shown promise in the treatment of ATTRv-CA; however, its efficacy and safety after liver transplantation are uncertain. In this preliminary retrospective review, we assessed the efficacy and safety of tafamidis (80 mg) in three ATTRv-CA cases after liver transplantation. Following one year of treatment, all patients experienced improvement in dyspnea, New York Heart Association functional class, brain natriuretic peptide levels, and cardiac troponin T levels. No significant changes in echocardiographic parameters were observed. Notably, no cardiovascular or drug-related adverse events occurred during treatment. Our findings suggest that tafamidis may benefit post-liver transplant patients with ATTRv-CA and warrant further investigation through randomized controlled trials with larger cohorts. This study highlights a potential therapeutic avenue for the management of cardiovascular involvement in this challenging patient population.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":"56 1","pages":"Article 103083"},"PeriodicalIF":4.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}