Antidiabetics: Structural Diversity of Molecules with a Common Aim

2018 ◽  
Vol 25 (18) ◽  
pp. 2140-2165 ◽  
Author(s):  
Jelena B. Popovic-Djordjevic ◽  
Ivana I. Jevtic ◽  
Tatjana P. Stanojkovic

Background: Diabetes mellitus type 2 (DMT2) is an endocrine disease of global proportions which is currently affecting 1 in 12 adults in the world, with still increasing prevalence. World Health Organization (WHO) declared this worldwide health problem, as an epidemic disease, to be the only non-infectious disease with such categorization. People with DMT2 are at increased risk of various complications and have shorter life expectancy. The main classes of oral antidiabetic drugs accessible today for DMT2 vary in their chemical composition, modes of action, safety profiles and tolerability. Methods: A systematic search of peer-reviewed scientific literature and public databases has been conducted. We included the most recent relevant research papers and data in respect to the focus of the present review. The quality of retrieved papers was assessed using standard tools. Results: The review highlights the chemical structural diversity of the molecules that have the common target-DMT2. So-called traditional antidiabetics as well as the newest and the least explored drugs include polypeptides and amino acid derivatives (insulin, glucagon-like peptide 1, dipeptidyl peptidase-IV inhibitors, amylin), sulfonylurea derivatives, benzylthiazolidine- 2,4-diones (peroxisome proliferator activated receptor-γ agonists/glitazones), condensed guanido core (metformin) and sugar-like molecules (α-glucosidase and sodium/ glucose co-transporter 2 inhibitors). Conclusion: As diabetes becomes a more common disease, interest in new pharmacological targets is on the rise.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ki-Soo Park ◽  
Gyeong-Ye Lee ◽  
Young-Mi Seo ◽  
Sung-Hyo Seo ◽  
Jun-Il Yoo

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Malika D. Shah ◽  
Ola Didrik Saugstad

Abstract After more than 1 year of the SARS-CoV-2 pandemic, a great deal of knowledge on how this virus affects pregnant women, the fetus and the newborn has accumulated. The gap between different guidelines how to handle newborn infants during this pandemic has been minimized, and the American Academy of Pediatrics (AAP)’s recommendations are now more in accordance with those of the World Health Organization (WHO). In this article we summarize present knowledge regarding transmission from mother to the fetus/newborn. Although both vertical and horizontal transmission are rare, SARS-CoV-2 positivity is associated with an increased risk of premature delivery and higher neonatal mortality and morbidity. Mode of delivery and cord clamping routines should not be affected by the mother’s SARS-CoV-2 status. Skin to skin contact, rooming in and breastfeeding are recommended with necessary hygiene precautions. Antibodies of infected or vaccinated women seem to cross both the placenta and into breast milk and likely provide protection for the newborn.


2021 ◽  
Vol 22 (9) ◽  
pp. 4670
Author(s):  
Cinzia Buccoliero ◽  
Manuela Dicarlo ◽  
Patrizia Pignataro ◽  
Francesco Gaccione ◽  
Silvia Colucci ◽  
...  

Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) is a protein that promotes transcription of numerous genes, particularly those responsible for the regulation of mitochondrial biogenesis. Evidence for a key role of PGC1α in bone metabolism is very recent. In vivo studies showed that PGC1α deletion negatively affects cortical thickness, trabecular organization and resistance to flexion, resulting in increased risk of fracture. Furthermore, in a mouse model of bone disease, PGC1α activation stimulates osteoblastic gene expression and inhibits atrogene transcription. PGC1α overexpression positively affects the activity of Sirtuin 3, a mitochondrial nicotinammide adenina dinucleotide (NAD)-dependent deacetylase, on osteoblastic differentiation. In vitro, PGC1α overexpression prevents the reduction of mitochondrial density, membrane potential and alkaline phosphatase activity caused by Sirtuin 3 knockdown in osteoblasts. Moreover, PGC1α influences the commitment of skeletal stem cells towards an osteogenic lineage, while negatively affects marrow adipose tissue accumulation. In this review, we will focus on recent findings about PGC1α action on bone metabolism, in vivo and in vitro, and in pathologies that cause bone loss, such as osteoporosis and type 2 diabetes.


2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Salman Tahir Shafi

In January 2020, the pathogen was identified and named by the World Health Organization as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The consequent SARS-CoV-2-related disease was defined as coronavirus disease 2019 (COVID-19). As data emerged about characteristics of the disease, it was found to be associated with increased risk of acute kidney injury (AKI). We explore the recent literature and reports emerging from the epicenters of the pandemic to help our viewers understand the nature of AKI among these patients. 


2020 ◽  
Vol 17 (1) ◽  
pp. 117-123
Author(s):  
N. G. Zumbulidze ◽  
V. M. Khokkanen ◽  
I. B. Litvin

According to statistical studies in recent decades, there has been an increase of allergic diseases in most countries of the world. Predisposing factors are the deterioration of the environmental situation, the total “chemicalization” of life and the forced use of drugs. Twenty years ago, the World Health Organization called the new century “the century of allergies” and the disease itself as an “epidemic”. As time has shown, these forecasts have come true: from 2001 to 2010, the number of allergic people in the world increased by 20 % and many of these patients suffer from ophthalmic manifestations of the pathology: the eyes are involved in the process in almost every second case. This is due to the fact that the eyes are directly exposed to the environment and a variety of external allergens. The most common disease of an eye-allergic nature is allergic conjunctivitis: approximately 15 % of the total population of economically developed countries suffer from it. Allergic blepharitis, eyelid dermatitis, keratitis, iritis, uveitis, retinitis and optic neuritis are much less common. The following manifestations are typical for allergic conjunctivitis: burning, lacrimation, pruritus, hyperemia of the eyelids and conjunctiva, photophobia. In the case of a transition to a chronic form, pronounced tissue changes are observed. Therefore, timely diagnosis and effective treatment certainly have a positive effect on the quality of life of the patient and the course of the disease. The treatment of patients with allergic conjunctivitis, first of all, consists in the maximum possible restriction of contact with the allergen. During desensitizing therapy, local and general drugs are used. Numerous studies have proven the advantage of targeted and effective antiallergic local therapy compared with systemic exposure. Currently used local ophthalmic antiallergic drugs belonging to various groups. The tactics of their use is determined by the acuity, severity and etiology of the process. When choosing a drug, in some cases, you should focus on the presence of substances that provide a double mechanism of action: a pronounced antihistamine activity in combination with the stabilization properties of mast cells, which has a quick and long therapeutic effect. This study evaluated efficacy of Vizallergol (olopatadin 0.2 %) application in cases of allergic conjunctivitis in 239 patients was evaluated. The medication arrested the symptoms of allergic conjunctivitis in 89 % of patients, at that the mean period of treatment made 10.7 ± 0.3 days. In the treatment of allergic conjunctivitis, the therapeutic efficacy of Vizallergol 0.2 % was comparable to opatanol 0.1 % and was found to be more comfortable for most patients due to the convenience of a single use.


Author(s):  
Elise Paul

Specific populations at risk for suicide differ considerably according to region, country, sex, age, and the most common suicide methods used, highlighting the need for ongoing systematic surveillance to inform prevention efforts. The magnitude of the problem is not limited to suicide deaths. It is estimated that for every suicide, there are 20 more persons who have made an attempt. Individuals who have made a suicide attempt are at increased risk for dying by suicide. This chapter explores differences in the suicide and suicide attempt rates in the general population on different continents, by examining data from the World Health Organization (WHO) Global Health Estimates and the World Mental Health Survey Initiative. Differences across contexts in suicidal behaviours and the need for ongoing monitoring are emphasized.


Depression ◽  
2018 ◽  
pp. 3-10
Author(s):  
Raymond W. Lam

Depression is a common condition with a lifetime prevalence of about 15%. People with depression experience significant impairment in psychosocial functioning, particularly in those with a recurrent or chronic course. Depression is now the leading cause of years lived with disability worldwide. Depression is also associated with increased risk of developing a medical illness and an increased risk of overall mortality, even when deaths from suicide are excluded. The economic costs of depression are staggering, largely owing to indirect costs associated with occupational impairment leading to work absence and reduced productivity. Depression remains undertreated, particularly in lower- and middle-income countries, but the World Health Organization has estimated that scaling up of depression treatment returns US$5 for every US$1 spent.


2019 ◽  
Vol 7 (6) ◽  
pp. 272-278
Author(s):  
Tess Hickson

A quarter of children in the UK are entering primary school either overweight or obese ( NHS Digital, 2017 ). These children have an increased risk of serious health consequences during their childhood years, which often continues into adulthood ( World Health Organization (WHO, 2017 ). A Healthy Weight Discussion Tool was created and introduced into a health visiting service to assist staff to identify and manage children presenting with excess weight. Three teams trialled its use, but uptake of this tool was low. A focus group evaluation was therefore carried out to examine the experience of staff using the tool. Although the tool was effective when implemented as intended, certain factors prevented its use in practice. These findings need to be addressed and the use of the tool re-evaluated to ascertain whether this service improvement will enhance the management of children with excess weight within the Universal service.


Author(s):  
Nicky J Mehtani ◽  
Lori Rosman ◽  
William J Moss

Abstract Children infected with human immunodeficiency virus (HIV) are at increased risk of measles morbidity and mortality. We searched abstracts from the PubMed, Embase, and Latin American and Caribbean Center on Health Sciences Information databases for articles published from the earliest date available through September 26, 2017. The primary outcome of interest was serological responses to measles vaccine, stratified by HIV infection status. A total of 2,858 potentially eligible articles were identified, and the final review included 12 studies published between 1992 and 2013, 9 of which reported data on vaccine safety. The studies we included represented 3,573 children, of whom at least 335 were infected with HIV, 788 were HIV-exposed but not infected, and 1,478 were unexposed to HIV. Four of the 12 studies found statistically significant reductions in seropositivity among HIV-infected children compared with HIV-uninfected children within 4 months of vaccination (prevalence ratio range, 0.44–0.70), and forest plots provided visual trends of decreasing immunity over time among HIV-infected children in 2 additional studies. No vaccine-related deaths or serious adverse events were reported. This updated review demonstrated limitations of the existing published literature but supported evidence of reduced immunogenicity of measles vaccine among HIV-infected children, supporting the World Health Organization recommendation to revaccinate HIV-infected children against measles following immune reconstitution with combination antiretroviral therapy.


Author(s):  
Anna Maria Geretti ◽  
Alexander J Stockdale ◽  
Sophie H Kelly ◽  
Muge Cevik ◽  
Simon Collins ◽  
...  

Abstract Background Evidence is conflicting about how human immunodeficiency virus (HIV) modulates coronavirus disease 2019 (COVID-19). We compared the presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the United Kingdom and whose data were prospectively captured by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) World Health Organization (WHO) Clinical Characterization Protocol (CCP) study. Methods We used Kaplan-Meier methods and Cox regression to describe the association between HIV status and day-28 mortality, after separate adjustment for sex, ethnicity, age, hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, 10 individual comorbidities, and disease severity at presentation (as defined by hypoxia or oxygen therapy). Results Among 47 592 patients, 122 (0.26%) had confirmed HIV infection, and 112/122 (91.8%) had a record of antiretroviral therapy. At presentation, HIV-positive people were younger (median 56 vs 74 years; P < .001) and had fewer comorbidities, more systemic symptoms and higher lymphocyte counts and C-reactive protein levels. The cumulative day-28 mortality was similar in the HIV-positive versus HIV-negative groups (26.7% vs. 32.1%; P = .16), but in those under 60 years of age HIV-positive status was associated with increased mortality (21.3% vs. 9.6%; P < .001 [log-rank test]). Mortality was higher among people with HIV after adjusting for age (adjusted hazard ratio [aHR] 1.47, 95% confidence interval [CI] 1.01–2.14; P = .05), and the association persisted after adjusting for the other variables (aHR 1.69; 95% CI 1.15–2.48; P = .008) and when restricting the analysis to people aged <60 years (aHR 2.87; 95% CI 1.70–4.84; P < .001). Conclusions HIV-positive status was associated with an increased risk of day-28 mortality among patients hospitalized for COVID-19.


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