Areas of Interest and Attitudes towards the Pharmacological Treatment of Attention Deficit Hyperactivity Disorder: Thematic and Quantitative Analysis Using Twitter

We focused on tweets containing hashtags related to ADHD pharmacotherapy between 20 September and 31 October 2019. Tweets were classified as to whether they described medical issues or not. Tweets with medical content were classified according to the topic they referred to: side effects, efficacy, or adherence. Furthermore, we classified any links included within a tweet as either scientific or non-scientific. We created a dataset of 6568 tweets: 4949 (75.4%) related to stimulants, 605 (9.2%) to non-stimulants and 1014 (15.4%) to alpha-2 agonists. Next, we manually analyzed 1810 tweets. In the end, 481 (48%) of the tweets in the stimulant group, 218 (71.9%) in the non-stimulant group and 162 (31.9%) in the alpha agonist group were considered classifiable. Stimulants accumulated the majority of tweets. Notably, the content that generated the highest frequency of tweets was that related to treatment efficacy, with alpha-2 agonist-related tweets accumulating the highest proportion of positive consideration. We found the highest percentages of tweets with scientific links in those posts related to alpha-2 agonists. Stimulant-related tweets obtained the highest proportion of likes and were the most disseminated within the Twitter community. Understanding the public view of these medications is necessary to design promotional strategies aimed at the appropriate population.

PPAR-Alpha Agonist Fenofibrate Combined with Octreotide Acetate in the Treatment of Acute Hyperlipidemia Pancreatitis

At present, there are more and more patients with acute hypertriglyceridemia pancreatitis in clinical practice. Common treatment measures include fasting and water withdrawal, fluid resuscitation, and somatostatin. In recent years, studies have pointed out that the PPARa agonist fenofibrate may help improve the condition of such patients. Therefore, through clinical research and analysis, we reported for the first time that fenofibrate combined with octreotide acetate has a more excellent effect in the treatment of patients with acute hypertriglyceridemia pancreatitis, and from the perspective of signal pathways, we revealed that the combination of the two drugs has an effect on NF-κB P65. The synergistic inhibitory effect proves that the combined treatment is beneficial to control inflammation, protect liver function, and improve the prognosis of patients. It is worthy of clinical promotion.

Areas of Interest and Attitudes Towards the Pharmacological Treatment of Attention Deficit Hyperactivity Disorder: Thematic and Quantitative Analysis Using Twitter (Preprint)

BACKGROUND The treatment of ADHD is complex and may involve behavioral, psychological and educational interventions, as well as medication. Different pharmacological treatments have shown efficacy in reducing ADHD symptoms and improving daily functioning. Analysis of tweets has become a tool for understanding perceptions by the general population on health issues. OBJECTIVE Investigate the gap existing between its extensive scientific support and the lack of widespread prescription and adherence. We hypothesize that such a discrepancy may be influenced by a lack of knowledge of the positive effects among the population. Thus, we find it interesting and worthwhile to assess opinions and social interest on ADHD pharmacotherapy in Twitter. METHODS In this observational quantitative and qualitative study we focused on tweets containing hashtags related to ADHD pharmacotherapy between September 20th and October 31st 2019. Tweets were first classified as to whether they described medical issues or not. Tweets with medical content were classified according to the topic they referred to: side effects, efficacy, or adherence. Furthermore, we classified any links included within a tweet as either scientific or non-scientific. RESULTS We collected a total of 118,388 tweets, 111,820 of which were excluded according to the criteria of the study. This process led to the creation of a more concise dataset of 6,568 tweets: 4,949 (75.4%) related to stimulants, 605 (9.2%) to non-stimulants and 1,014 (15.4%) to alpha-2-agonists. Next, we manually analyzed 1,810 tweets: 1,000 tweets related to stimulants, 303 to non-stimulants and 507 to alpha-agonists. In the end, 481 (48%) of the tweets in the stimulant group, 218 (71.9%) in the non-stimulant group and 162 (31.9%) in the alpha-agonist group were considered classifiable according to the codebook. Stimulants accumulated the majority of tweets. Notably, the content that generated the highest frequency of tweets was that related to treatment efficacy, with alpha-2-agonists related tweets accumulating the highest proportion of positive consideration. We found the highest percentages of tweets with scientific links in those posts related alpha-2-agonists. CONCLUSIONS Stimulants related tweets obtained the highest probability of likes and were the most disseminated within the Twitter community. Understanding the public view of these medications is necessary to design promotional strategies aimed at the appropriate population.

A Clinical Comparative Study between Epidurally Administered Ropivacaine 0.2 % and Ropivacaine 0.2 % with Clonidine for Post-Operative Analgesia in Lower Limb and Abdominal Surgeries

BACKGROUND There are many modalities to give postoperative analgesia. Out of them epidural analgesia offers good reliable pain relief. Addition of alpha agonist enhances the onset of analgesia and duration of analgesia is prolonged. This study was done to compare the analgesic efficacy, and the hemodynamic parameters of ropivacaine compared with ropivacaine in combination with clonidine for post-operative epidural analgesia. METHODS 30 patients of age 18 - 70 years with ASA grade of I & II, undergoing elective lower limb and abdominal surgeries were randomly taken into each of the 2 groups. Group R received 0.2 % ropivacaine and group RC received 0.2 % ropivacaine + clonidine (1 mcg / Kg) epidurally.1,2 Patients were monitored for onset, duration, quality of analgesia, cardiorespiratory stability and side effects. RESULTS The onset of analgesia and quality of analgesia were better in the RC group compared to the R group. The duration of analgesia in group RC (9.43 + - 1.17 hours) was found to be significantly prolonged than group R (4.90 + - 1.03 hours) with p < 0.001. Blood pressure was more stable in group RC compared to group R. CONCLUSIONS In this study we found that ropivacaine with clonidine as epidural postoperative analgesia provided superior and more effective analgesia when compared to ropivacaine. The duration of analgesia was significantly longer in group ropivacaine with clonidine. KEYWORDS Ropivacaine, Clonidine, Post-operative Analgesia, Epidural

Gut-liver axis modulation in fructose-fed mice: a role for PPAR-alpha and linagliptin

Fructose dietary intake affects the composition of the intestinal microbiota and influences the development of hepatic steatosis. Endotoxins produced by gram-negative bacteria alter intestinal permeability and cause bacterial translocation. This study evaluated the effects of gut microbiota modulation by a purified PPAR-alpha agonist (WY14643), a DPP-4 inhibitor (linagliptin), or their association on intestinal barrier integrity, endotoxemia, and hepatic energy metabolism in high-fructose-fed C57BL/6 mice. Fifty mice were divided to receive the control diet (C group) or the high-fructose diet (HFRU) for 12 weeks. Subsequently, the HFRU group was divided to initiate the treatment with PPAR-alpha agonist (3.5 mg/kg/BM) and DPP-4 inhibitor (15 mg/kg/BM). The HFRU group had glucose intolerance, endotoxemia, and dysbiosis (with increased Proteobacteria) without changes in body mass in comparison with the C group. HFRU group showed damaged intestinal ultrastructure, which led to liver inflammation and marked hepatic steatosis in the HFRU group when compared to the C group. PPAR-alpha activation and DPP-4 inhibition countered glucose intolerance, endotoxemia, and dysbiosis, ameliorating the ultrastructure of the intestinal barrier and reducing Tlr4 expression in the liver of treated animals. These beneficial effects suppressed lipogenesis and mitigated hepatic steatosis. In conclusion, the results herein propose a role for PPAR-alpha activation, DPP-4 inhibition, and their association in attenuating hepatic steatosis by gut-liver axis modulation in high-fructose mice model. These observations suggest these treatments as potential targets to treat hepatic steatosis and avoid its progression.