Overview on Renovascular Hypertension: Review Article

Renovascular hypertension (RVH) is a prevalent cause of secondary hypertension that frequently develops to resistant hypertension. It is characterised as systemic hypertension that develops as a result of a restricted blood supply to the kidneys. Patients cannot be recognized clinically from those with essential hypertension; therefore, diagnosis requires arteriography, however urography and isotope renography may hint to the diagnosis. Atherosclerotic renal artery stenosis (ARAS) and fibromuscular dysplasia are the two most prevalent causes of RVH. The ultimate objective of controlling RVH, like with other kinds of hypertension, is to minimize the morbidity and mortality associated with high blood pressure The widespread use of effective antihypertensive medication treatment, statins, and other strategies to control vascular disease has resulted in remarkable improvements. In this review we will be looking at etiology, pathogenesis and treatment or RVH.

Studies on the combinations of some herbals with various chemical entities as a potent antifungal agents

A widespread increase in the prevalence of fungal infections has been documented in recent decades. Candida albicans infections, which are frequently refractory and linked with high morbidity and mortality, place a significant burden on public health, despite the fact that existing antifungal medicines are restricted and associated with toxicity. Fungi are one of the most underappreciated killers, as evidenced by the fact that Amphotericin B and other commercially available antifungal therapies are still recognized as gold standards. The majority of commonly used antifungal medications have toxicity, effectiveness, and cost disadvantages. As a result of these limitations, there is a growing demand for the development of a novel antifungal medication treatment that acts selectively on new targets while having the fewest adverse effects. Natural goods, whether as pure phytocompounds or regulated plant extracts, give prospects for the development of lead compounds that may subsequently be turned into diverse synthetic medications with the appropriate alterations. These herbs can also be used as a component of a herbal synthetic combination, lowering the minimum required dose of the synthetic medicine (when taken singly) and reducing the risk of adverse effects. The goal of this research is to reduce the minimum required concentrations of today's antifungal medications by mixing them with a few less well-known herbal extracts while maintaining their efficacy.

Underrepresented patient views and perceptions of personalized medication treatment through pharmacogenomics

Within an institutional pharmacogenomics implementation program, we surveyed 463 outpatients completing preemptive pharmacogenomic testing whose genetic results were available to providers for guiding medication treatment. We compared views and experiences from self-reported White and Black patients, including education level as a covariate across analyses. Black patients were less confident about whether their providers made personalized treatment decisions, and overwhelmingly wanted a greater role for their genetic information in clinical care. Both groups similarly reported that providers asked their opinions regarding medication changes, but White patients were more likely (59% vs. 49%, P = 0.005) to discuss the impact of personal/genetic makeup on medication response with providers, and Black patients reported initiating such discussions much less frequently (4% vs. 15%, P = 0.037). Opportunities exist for enhanced communication with underrepresented patients around personalized care. Tailored communication strategies and development of support tools employed in diverse healthcare settings may facilitate pharmacogenomically guided medication treatment that equitably benefits minority patient populations.

Xerostomia among elderly patients – systematic review

Introduction and purpose: Xerostomia is a salivary secretion malfunction that affects from 1 to 29% of the population. It is a common problem among elderly patients, however undeniably it still remains an underdiagnosed issue. Searching among available literature in the PubMed database with the following phrases: xerostomia; elderly, the aim of this article was to provide a broad review on the underdiagnosed problem which is xerostomia among elderly patients. Description: A group at risk of developing xerostomia are people over 65 years old and women in the perimenopausal period. Although dry mouth varies in etiology, geriatric patients mostly develop xerostomia as a result of head and neck radiotherapy, Sjögren syndrome or medication treatment. Untreated symptoms can lead to severe issues which heavily impact not only oral health of the patient, but also their everyday life quality, since xerostomia may lead into difficulty of speaking, swallowing and tasting. The plan of treatment is influenced by the etiology of the case, however it is aimed to stimulate salivary flow and eradicate the use of unnecessary medication which may cause dry mouth. Prevention of dry mouth is based on maintenance of good oral hygiene. Conclusions: Diagnosing the problem early can prevent patients from suffering the consequences of chronic xerostomia, therefore awareness should be brought to this issue. Dentist could also highly improve the quality of xerostomic patient’s life, if the chosen treatment significantly improved patient’s symptoms.

Transforming Opioid Addictions Care in New Mexico: Combining Medication Treatment with Patient Autonomy, Civic Engagement and Integrative Healing

Opioid addiction is a complex issue. New Mexico has historically experienced some of the highest rates of deaths from opioid overdose, and opioid addictions have affected generations of New Mexicans -- starting many years before the more recent national crisis. Treatment approaches to opioid and other addictions are fraught with paternalism, stigma, surveillance, criminalization, shaming, racism, discrimination, and issues with access to care. Current treatment paradigms fail to take into account the social and economic factors of people, community, and context. New paradigms embracing a broader, more-just contextualization of addictions, along with evidence-based treatment approaches are needed to transform medicine’s historic role in the “war on drugs”. The Strong Roots/Raices Fuertes program was developed by two community clinics, Casa de Salud and Centro Sávila, in Albuquerque, New Mexico. The program evolved from a desire to to acknowledge and right historical harms that the medical-industrial complex has caused; to provide rapid access to dignified, life-saving, evidence-based holistic treatment for opioid addictions in a community setting; and to build a model of care that transforms the biomedical model into one of solidarity with community and collective care. Five key concepts underpin the program design: 1) Harm Reduction, Autonomy, and Agency; 2) Healing-Centered Engagement; 3) Language and Cultural Humility; 4) Transforming Health Systems Design; 5) Workforce Diversity and Pipeline Training. The program’s core components include conventional approaches such as low-barrier access buprenorphine (suboxone®) to medication treatment, primary care, case management, syringe exchange, and counseling/therapy in addition to more community-rooted and integrative healing modalities such as healing circles, acupuncture, massage, reiki, ear acudetox, and civic engagement. In sharing the values, lessons learned, and tools from our work in the Strong Roots/Raices Fuertes program, we hope to inspire and encourage others wishing to develop new systems of care for people dealing with addiction issues.