scholarly journals Nutraceutical Approach to Chronic Osteoarthritis: From Molecular Research to Clinical Evidence

2021 ◽  
Vol 22 (23) ◽  
pp. 12920
Author(s):  
Alessandro Colletti ◽  
Arrigo F. G. Cicero
Keyword(s):  
Molecular Mechanisms ◽  
Clinical Evidence ◽  
Joint Stiffness ◽  
Efficacy And Safety ◽  
The World ◽  
Inflammatory Drugs ◽  
Arthritic Joints ◽  
Current Guidelines ◽  
Heterogeneous Class

Osteoarthritis (OA) is a degenerative inflammatory condition of the joint cartilage that currently affects approximately 58 million adults in the world. It is characterized by pain, stiffness, and a reduced range of motion with regard to the arthritic joints. These symptoms can cause in the long term a greater risk of overweight/obesity, diabetes mellitus, and falls and fractures. Although the current guidelines for the treatment of OA suggest, as the gold standard for this condition, pharmacological treatment characterized by non-steroidal anti-inflammatory drugs (NSAID), opioids, and cyclooxygenase (COX)-2-specific drugs, a great interest has been applied to nutraceutical supplements, which include a heterogeneous class of molecules with great potential to reduce inflammation, oxidative stress, pain, and joint stiffness and improve cartilage formation. The purpose of this review is to describe the potential application of nutraceuticals in OA, highlighting its molecular mechanisms of actions and data of efficacy and safety (when available).

scholarly journals Cardiac Cell Therapy: Insights into the Mechanisms of Tissue Repair

2021 ◽  
Vol 22 (3) ◽  
pp. 1201
Author(s):  
Hsuan Peng ◽  
Kazuhiro Shindo ◽  
Renée R. Donahue ◽  
Ahmed Abdel-Latif
Keyword(s):  
Stem Cell ◽  
Immune Responses ◽  
Tissue Repair ◽  
Molecular Mechanisms ◽  
Clinical Evidence ◽  
Current Knowledge ◽  
Cell Delivery ◽  
Cardiac Cell Therapy ◽  
Stem Cell Treatment

Stem cell-based cardiac therapies have been extensively studied in recent years. However, the efficacy of cell delivery, engraftment, and differentiation post-transplant remain continuous challenges and represent opportunities to further refine our current strategies. Despite limited long-term cardiac retention, stem cell treatment leads to sustained cardiac benefit following myocardial infarction (MI). This review summarizes the current knowledge on stem cell based cardiac immunomodulation by highlighting the cellular and molecular mechanisms of different immune responses to mesenchymal stem cells (MSCs) and their secretory factors. This review also addresses the clinical evidence in the field.

scholarly journals The world of synbiotics: a review of literature and clinical evidence in diarrhoea from the lens of a paediatrician

2018 ◽  
Vol 6 (1) ◽  
pp. 233
Author(s):  
Pramod Jog
Keyword(s):  
Clinical Evidence ◽  
Lactobacillus Rhamnosus ◽  
Acute Diarrhoea ◽  
Efficacy And Safety ◽  
Review Of Literature ◽  
Rota Virus ◽  
Lactobacillus Rhamnosus Gg ◽  
Virus Origin ◽  
The World ◽  
Better Than

The use of synbiotics in the management of acute diarrhoea in children is becoming a common practice in India. However, since this is an upcoming modality of treatment, it is essential to review the scientific rationale and evidence on clinical efficacy and safety in the context of paediatric diarrhoea. In addition, most synbiotics contain a combination of multiple probiotics along with a prebiotic. Thus arises, a parallel need to understand whether a combination of probiotics performs better than single probiotics, hence justifying the rationale for such combinations. A review of available evidence suggests that synbiotics are indeed safe and superior in efficacy to single probiotics (like Bacillus clausii, Lactobacillus rhamnosus GG etc) and that there is a good body of evidence to support the efficacy and tolerability of synbiotics in the management of paediatric acute gastroenteritis. There is also evidence to suggest that combination probiotics have superior benefits compared to single probiotics, thus justifying their use as part of synbiotics. The overall benefits of synbiotics reported in various clinical trials on paediatric diarrhoea include, a rapid normalization of the gastrointestinal flora, a reduction in the duration of diarrhoea, quicker improvement in stool consistency, lesser administration of additional medications like antibiotics, antiemetics and antipyretics, higher physician reported treatment satisfaction scores and enhanced overall efficacy against gastrointestinal pathogens, including diarrhoea of rota virus origin. Hence, synbiotics put up a strong case to look beyond probiotics and single probiotic formulations in paediatric diarrhoea.

scholarly journals Comparative efficacy and safety of current drugs against COVID-19: A systematic review and network meta-analysis

2020 ◽  
Author(s):  
Yi Li ◽  
Wei He
Keyword(s):  
Systematic Review ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Clinical Decision ◽  
Added Value ◽  
Efficacy And Safety ◽  
Outcome Indicators ◽  
Rapid Spread ◽  
The World ◽  
Significant Health

AbstractThe rapid spread of coronavirus disease (COVID-19) has greatly disrupted the livelihood of many people around the world. To date, more than 35.16 million COVID-19 cases with 1.037million total deaths have been reported worldwide. Compared with China, where the disease was first reported, cases of COVID-19, the number of confirmed cases for the disease in the rest of the world have been incredibly high. Even though several dugs have been suggested to be used against the disease, the said interventions should be backed by empirical clinical evidence. Therefore, this paper provides a systematic review and a meta-analysis of efficacy and safety of different COVID-19 drugs.Research in contextEvidence before this studyCurrently, Covid-19 is one of the most urgent and significant health challenge, globally. However, so far there is no specific and effective treatment strategy against the disease. Nonetheless, there are numerous debates over the effectiveness and potential adverse effects of different COVID-19 antivirals. In general, there is invaluable need to continually report on new advances and successes against COVID-19, apparently to aid in managing the pandemic.Added value of this studyThis study provides a comprehensive, evidence-based guide on the management of multiple COVID-19 symptoms. In particular, we provide a review of 14 drugs, placebos and standard treatments against COVID 19. Meanwhile, we also performed a meta-analysis based on four clinical outcome indicators, to measure and compare the efficacy and safety of current interventions.Implications of all the available evidenceFindings of this research will guide clinical decision in COVID-19 patients. It will also provide a basis for predicting clinical outcomes such as efficacy, mortality and safety of interventions against the disease.

The Physiology of Optimizing Health with a Focus on Exercise as Medicine

2019 ◽  
Vol 81 (1) ◽  
pp. 607-627 ◽  
Author(s):  
Bente Klarlund Pedersen
Keyword(s):  
Physical Inactivity ◽  
Clinical Evidence ◽  
Basic Research ◽  
Abdominal Adiposity ◽  
Major Health ◽  
The World ◽  
Knowledge And Practice ◽  
Anti Inflammatory ◽  
Multiple Signaling

Physical inactivity is one of the leading health problems in the world. Strong epidemiological and clinical evidence demonstrates that exercise decreases the risk of more than 35 different disorders and that exercise should be prescribed as medicine for many chronic diseases. The physiology and molecular biology of exercise suggests that exercise activates multiple signaling pathways of major health importance. An anti-inflammatory environment is produced with each bout of exercise, and long-term anti-inflammatory effects are mediated via an effect on abdominal adiposity. There is, however, a need to close the gap between knowledge and practice and assure that basic research is translated, implemented, and anchored in society, leading to change of praxis and political statements. In order to make more people move, we need a true translational perspective on exercise as medicine, from molecular and physiological events to infrastructure and architecture, with direct implications for clinical practice and public health.

scholarly journals NSAID enteropathy

2020 ◽  
Vol 92 (2) ◽  
pp. 85-92
Author(s):  
E. N. Kareva
Keyword(s):  
Small Intestine ◽  
Therapeutic Strategy ◽  
Intestinal Flora ◽  
Nsaid Enteropathy ◽  
The World ◽  
Prevention And Treatment ◽  
Nsaid Gastropathy ◽  
Inflammatory Drugs ◽  
Very High

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used drugs in the world, and their side effects are very high. First of all, these are NSAID gastropathy, but in the long term, 5070% of NSAIDs cause damage to the small intestine (NSAID enteropathy), sometimes with serious consequences. To date, no drugs have been proposed with proven effectiveness to prevent this side effect. Apparently, this is not due to the fully clarified mechanism of pathogenesis. The most promising is the hypothesis of the participation of individual representatives of microflora in the development of enteropathy. Therefore, modulating the intestinal flora with the help of probiotics can be the basic therapeutic strategy for the prevention and treatment of such damage.

scholarly journals Insulin biosimilars in clinical practice

2022 ◽  
pp. 131-138
Author(s):  
A. F. Verbovoy ◽  
Yu. A. Dolgikh ◽  
L. A. Sharonova
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Studies ◽  
Basal Insulin ◽  
Efficacy And Safety ◽  
Biological Product ◽  
Duration Of Action ◽  
Reference Drug ◽  
The World

Diabetes mellitus (DM) is an important medical and social problem throughout the world due to its high prevalence. At the same time, the majority of patients have type 2 diabetes. The onset of the disease is gradual, with a prolonged asymptomatic preclinical stage. Therefore, it is necessary to conduct screening among patients at risk. Therapy for type 2 diabetes is carried out with oral hypoglycemic drugs. If it is impossible with their help to achieve adequate glycemic control, it is possible to add basal insulin to therapy, and if the own insulin secretion is depleted, an intensive insulin therapy regimen must be prescribed. Insulin preparations differ in the source of receipt, as well as in the duration of action: background, or basal (insulin of medium duration, long-term or ultra-long-acting) and prandial, or food (ultrashort and short insulin). Currently, along with original insulin preparations, their analogues, or biosimilars (biosimilars), appear on the pharmaceutical market. Biosimilar (biosimilar) is a biological product similar in quality, efficacy and safety parameters to a reference biological medicinal product in the same dosage form and having an identical route of administration. Biosimilars are used all over the world, and this applies not only to insulin preparations, but also to other biological preparations. Proof of bioequivalence is a long-term process that ensures comparability and the absence of clinically significant differences between the study and the reference drug, and includes preclinical and clinical studies. The task of studies of biosimilars of insulin is to confirm the comparability with a reference, previously well-studied biological product. The efficacy and safety of domestically produced biosimilars has been studied in a number of clinical studies, during which the bioequivalence of the drugs was shown. These drugs are of high quality and safe, and their pharmacological characteristics, immunogenicity and effectiveness do not differ from the original drugs.

scholarly journals Advance on synthesis, pharmacokinetics, and pharmacodynamics of the anti-epileptic drug: Levetiracetam

2020 ◽  
Vol 185 ◽  
pp. 03006
Author(s):  
Wei Wang
Keyword(s):  
Efficacy And Safety ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Broad Application ◽  
The Past ◽  
Equal Importance ◽  
Anti Epileptic Drug ◽  
The World ◽  
Unique Mechanism ◽  
Application Prospects

Over the past few decades, many patients around the world have suffered from epilepsy, and epilepsy treatment is a long-term process. Thus, the safety and efficacy of medication for epilepsy are of equal importance. Levetiracetam is a second-generation anti-epileptic drug with a unique mechanism of action, good anti-epileptic efficacy, and safety. The therapeutic field has broad application prospects because levetiracetam offers several advantages over other anti-epileptic drugs. In this review, the synthesis, pharmacokinetics, pharmacodynamics, and reverse reaction of levetiracetam were summarized and discussed. This paper will be helpful for the development and application of levetiracetam.

Rational Use of Second-Generation Antipsychotics for the Treatment of ICU Delirium

2016 ◽  
Vol 30 (1) ◽  
pp. 121-129 ◽  
Author(s):  
Yoonsun Mo ◽  
Felix K. Yam
Keyword(s):  
Cognitive Deficits ◽  
Second Generation ◽  
Clinical Evidence ◽  
Safety Properties ◽  
Pharmacological Interventions ◽  
Rational Use ◽  
Second Generation Antipsychotics ◽  
Icu Delirium ◽  
Current Guidelines

Delirium, described as an acute neuropsychiatric syndrome, occurs commonly in critically ill patients and leads to many negative outcomes including increased mortality and long-term cognitive deficits. Despite the lack of clinical data supporting the use of antipsychotics for the management of intensive care unit (ICU) delirium, pharmacological interventions are often needed to control acutely agitated patients. Given that the most current guidelines do not advocate the use of haloperidol for either the prevention or treatment of ICU delirium due to a lack of evidence, second-generation antipsychotics (SGAs) have been commonly used as alternatives to haloperidol for ICU patients with delirium. Nonetheless, the evidence supporting the use of SGAs to treat ICU delirium remains limited. This review is designed to assess the available clinical evidence and highlights the different neuropharmacological and safety properties of SGAs in order to guide the rational use of SGAs for the treatment of ICU delirium.

scholarly journals Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Simone de Souza Nascimento ◽  
Josimari Melo DeSantana ◽  
Fernando Kenji Nampo ◽  
Êurica Adélia Nogueira Ribeiro ◽  
Daniel Lira da Silva ◽  
...  
Keyword(s):  
Natural Products ◽  
Medicinal Plants ◽  
Methodological Quality ◽  
Joint Stiffness ◽  
Risk Of Bias ◽  
Sleep Disruption ◽  
Efficacy And Safety ◽  
Conventional Drug

To assess the effects of medicinal plants (MPs) or related natural products (RNPs) on fibromyalgia (FM) patients, we evaluate the possible benefits and advantages of MP or RNP for the treatment of FM based on eight randomized placebo-controlled trials (RCTs) involving 475 patients. The methodological quality of all studies included was determined according to JADAD and “Risk of Bias” with the criteria in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Evidence suggests significant benefits of MP or RNP in sleep disruption, pain, depression, joint stiffness, anxiety, physical function, and quality of life. Our results demonstrated that MP or RNP had significant effects on improving the symptoms of FM compared to conventional drug or placebo; longer tests are required to determine the duration of the treatment and characterize the long-term safety of using MP, thus suggesting effective alternative therapies in the treatment of pain with minimized side effects.

ETODOLAC, A WELL KNOWN AND ACTIVELY USED DRUG IN DIFFERENT COUNTRIES OF THE WORLD. WOULD IT BE TIME FOR US?

2019 ◽  
Vol 57 (4) ◽  
pp. 468-473
Author(s):  
A. E. Karateev
Keyword(s):  
Pain Control ◽  
Low Frequency ◽  
Efficacy And Safety ◽  
Gastrointestinal Complications ◽  
Surgical Interventions ◽  
Inflammatory Agent ◽  
Nsaid Group ◽  
The World ◽  
Anti Inflammatory

Etodolac is a nonsteroidal anti-inflammatory drug (NSAID), a moderately selective cyclooxygenase-2 inhibitor, which has been already used in clinical practice for more than 30 years as a universal analgesic and anti-inflammatory agent. Etodolac has proven itself in relieving acute pain associated with injuries and surgical interventions (particularly in dentistry). However, the main point of application of etodolac is long-term pain control in chronic rheumatic diseases, such as osteoarthritis and rheumatoid arthritis. Numerous clinical trials have shown that etodolac is at least not inferior in its therapeutic effect to many other popular representatives of the NSAID group or exceeds them. The main advantage of etodolac is the low frequency of gastrointestinal complications. This review presents the basic data available in the literature on the efficacy and safety of etodolac.

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