Drug

药物
  • 文章类型: Journal Article
    动脉粥样硬化性心血管疾病(ASCVD)仍然是全球主要的死亡原因之一,冠状动脉疾病(CAD)是ASCVD的最常见形式。2型糖尿病(DM)患者在病程中发生ASCVD的风险增加,CAD是受影响个体中最常见的死亡原因,导致幸存者的预期寿命缩短和发病率增加。最近,2类新型抗糖尿病药物,即钠-葡萄糖共转运蛋白-2(SGLT-2)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂,对2型糖尿病患者显示出令人印象深刻的心肾益处,即使在没有基线DM的情况下,它们也可能降低心肾风险。然而,迄今为止,尚无证据证明其在急性冠脉综合征(ACS)事件中的安全性和有效性,无论是否伴随DM。本研究旨在提供详细的,关于SGLT-2抑制剂和GLP-1受体激动剂在ACS中的潜在作用的现有临床证据的最新介绍,并强调这些药物类别是否可以在这一特定患者群体中用作标准治疗的辅助手段,以及潜在的短期和长期心血管益处的介绍。
    Atherosclerotic Cardiovascular Disease (ASCVD) is still one of the leading causes of death globally, with Coronary Artery Disease (CAD) being the most prevalent form of ASCVD. Patients with type 2 Diabetes Mellitus (DM) experience an increased risk for ASCVD during the disease course, with CAD being the most common cause of death among affected individuals, resulting in shorter life expectancy and increased morbidity among survivors. Recently, 2 novel classes of anti-diabetic drugs, namely Sodium-Glucose co-Transporter-2 (SGLT-2) inhibitors and Glucagon-Like Peptide-1 (GLP-1) receptor agonists, have shown impressive cardio-renal benefits for patients with type 2 DM, while they might decrease cardio-renal risk even in the absence of baseline DM. However, there is no evidence to date regarding their safety and efficacy in the setting of an acute coronary syndrome (ACS) event, regardless of concomitant DM. This study aims to provide a detailed, updated presentation of currently available clinical evidence concerning the potential role of SGLT-2 inhibitors and GLP-1 receptor agonists in the setting of an ACS, and to highlight whether those drug classes could be utilized as adjuncts to standard-of-care treatment in this specific patient population, along with a presentation of the potential short- and long-term cardiovascular benefits.
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  • 文章类型: Systematic Review
    药物诱导的皮肌炎(DIDM)是皮肌炎(DM)的一种罕见且被低估的变体,其特征是肌肉损伤和皮疹,并且与某些药物接触有关。引起DIDM的药物谱随着时间的推移而演变,最初涉及羟基脲,青霉胺,和他汀类药物作为病原体。肿瘤坏死因子α抑制剂和免疫检查点抑制剂也与此类病症相关。为了弥合当前文献与临床实践之间的差距,因此指导临床医生,我们对Pubmed的英语文献进行了全面的回顾,EMBASE,和MEDLINE。我们的分析包括人口统计数据,临床特征,实验室发现,治疗结果,以及各种药物诱导的DIDM可能发病机制的现有研究。此外,我们将涉及DIDM病例的药物分为生物制剂和传统药物,用于后续统计分析.随着时间的推移,报告的DIDM病例逐渐积累。我们的研究共记录了69例已发表的DIDM病例,其中33项应归因于生物制剂,其余36项应归因于传统药物。有趣的是,所有DIDM病例中有41例有恶性肿瘤病史。此外,DIDM病例表现出与经典DM相似的皮肤和肌肉表现,除了由羟基脲引起的病例,这并不意味着肌肉损伤。在生物制剂诱导的病例中主要观察到阳性抗核抗体和抗TIF1-γ自身抗体,而阳性抗TIF1-γ抗体仅在主要诊断为恶性疾病并随后暴露于ICIs的病例中报告。抗TIF1-γ抗体可能在鉴定DM患者共存的恶性疾病中起潜在的危险信号。我们还对药物诱发的皮肌炎背后的潜在机制进行了全面的总结和探索。总之,我们的评论巩固了目前关于DIDM的文献,强调不断发展的药物谱,阐明临床表现的差异,实验室发现,和潜在的机制。
    Drug-induced dermatomyositis (DIDM) is a rare and underestimated variant of dermatomyositis (DM) characterized by muscle damage and skin rash and related to certain drug exposure. The spectrum of drugs causing DIDM has evolved over time, originally implicating hydroxyurea, penicillamine, and statins as causative agents. Tumor necrosis factor α inhibitors and immune checkpoint inhibitors have also been associated with such conditions. To bridge the gap between current literature and clinical practice, and therefore guide clinicians, we conducted a comprehensive review of English literature from Pubmed, EMBASE, and MEDLINE. Our analysis included demographic data, clinical features, laboratory findings, therapeutic outcomes, and extant research pertaining to the probable pathogenesis of DIDM induced by various drugs. Furthermore, we categorized the drugs involved in DIDM cases into biologics and traditional agents for subsequent statistical analysis. Over time, there has been a gradual accumulation of reported DIDM cases. A total of 69 published DIDM cases were documented in our study, among which 33 should be attributed to biologics and the remaining 36 to traditional drugs. Interestingly, 41 of all DIDM cases had a previous history of malignancies. Additionally, DIDM cases exhibited similar cutaneous and muscular manifestations to classic DM, with the exception of cases induced by hydroxyurea, which did not entail muscle damage. Positive antinuclear antibodies and anti-TIF1-γ autoantibodies have been predominantly observed in biologics-induced cases, while positive anti-TIF1-γ antibodies were merely reported in the cases that were primarily diagnosed with malignant diseases and exposed to ICIs afterwards. Anti-TIF1-γ antibodies may potentially serve as a red flag in the identification of co-existing malignant diseases in DM patients. We also provided a comprehensive summary and exploration of potential mechanisms lying behind drug-induced dermatomyositis. In conclusion, our review consolidates the current literature on DIDM, highlighting the evolving spectrum of medications and elucidating the differences in clinical manifestations, laboratory findings, and underlying mechanisms.
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  • 文章类型: Journal Article
    药物治疗是影响虚弱的潜在因素。然而,药物治疗与虚弱之间的关系尚不清楚.因此,我们进行了本系统综述,目的是总结药物治疗与老年人体弱事件风险之间的关系.我们系统地搜索了MEDLINE电子数据库,以查找2000年1月1日至2021年12月31日之间的文章,以获得随机对照试验(RCT)和队列研究报告与药物治疗相关的脆弱变化。总共确定了6项RCT和13项队列研究,涉及211,948名参与者。他们的治疗分为六种药物:镇痛药,心脏代谢药物,化疗,中枢神经系统(CNS)活性药物,激素治疗,和营养补充剂。虽然分析显示,只有中枢神经系统活性药物与虚弱的风险升高有关,其他药物类别也影响了虚弱;然而,这并不能完全归因于整个阶级的影响。
    Medication is a potential factor influencing frailty. However, the relationship between pharmaceutical treatments and frailty remains unclear. Therefore, we conducted the present systematic review to summarize the association between drug therapy and the risk of incident frailty in older adults. We systematically searched the MEDLINE electronic database for articles indexed between January 1, 2000, and December 31, 2021, for randomized controlled trials (RCTs) and cohort studies reporting frailty changes associated with drug therapy. A total of 6 RCTs and 13 cohort studies involving 211,948 participants were identified, and their treatments were categorized into six medication classes: analgesics, cardiometabolic medication, chemotherapy, central nervous system (CNS)-active medication, hormonal therapy, and nutritional supplements. While the analysis revealed that only CNS-active medications were associated with an elevated risk of frailty, other medication classes also affected frailty; however, this is not conclusively attributable to a class-wide effect.
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  • 文章类型: Journal Article
    暂无摘要。
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    文章类型: Journal Article
    Fire-related burns contribute significantly to the global burden of burn injury and mortality. Alcohol and/or drug intoxication poses a risk to burn and fire-related injury, whether intentional or unintentional, but such evidence is scarce in the African context. This review aimed to fill the knowledge gap on health determinants of fire-related morbidity and mortality regionally by investigating the role of alcohol and drug intoxication in such events. Using key concepts, an extensive search was performed on 25 databases for relevant publications. Eligible articles were critically appraised using the appraisal tool for cross-sectional studies (AXIS tool), adapted to the review\'s objectives and outcomes. A total of 42 articles were included, of which less than half were solely investigating burn/fire-related events. Others indirectly mentioned burn injuries as part of larger health burdens such as injury, trauma, violence and other diseases. The measurement of alcohol and/or drug intoxication was inconsistent between studies with varying results. Alcohol and drug impairment in burn incidents in Africa requires evidence-based epidemiological research, and this review illustrated the limited scope of this topic in current literature. Routine toxicological results from post-mortem examinations were identified as important data sources and several research recommendations were provided.
    Les atteintes lors d’un incendie représentent une partie non négligeable de l’ensemble des brûlures. Qu’elle soit intentionnelle ou non, l’intoxication alcoolique et/ou par stupéfiant en augmente le risque. Mais les données à ce sujet sont rares en Afrique. Nous avons effectué une revue systématique sur 25 banques de données. Les 42 articles sélectionnés, dont moins de la moitié exploraient les brûlures lors d’un incendie (les autres comprenaient les brûlures dans un cadre traumatique plus général- blessure, traumatisme, violence, etc.), ont été étudiés selon la méthode AXIS. La mesure de l’alcoolémie et les recherches de toxiques étaient variablement reprises dans les articles, le diagnostic d’intoxication reposant essentiellement sur la clinique en Afrique et il y a donc peu de données basées sur des chiffres, les plus fréquentes étant celles provenant de prélèvements autopsiques. Il s’agit donc d’améliorer le diagnostic de ces intoxications en cas de brûlure lors d’un incendie.
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  • 文章类型: Journal Article
    背景:在怀孕期间,女人的身体经历解剖和生理变化,使这一时期容易发生母胎疾病和并发症。不治疗孕妇的后果包括早产,低出生体重胎儿,和产后行为障碍。开发新的疗法可以加速发现安全有效的药物,有助于设计新颖的天然和合成产品来治疗妊娠并发症。
    目的:本研究旨在进行专利综述,以确定和探索治疗孕妇的创新和治疗策略的趋势。
    方法:使用Espacenet和WIPO数据库,纳入标准是关键词“怀孕和药物”和代码A61k,从2008年到2023年,被排除在外的是获得专利和关注人类孕妇。
    结果:在最终筛查后,32项专利入选,治疗孕妇疾病的策略。其中,20项专利是关于动物的临床前研究,12项关于孕妇。据观察,大学在申请排名中领先(17/32),中国拥有最多的专利(18/32)。大多数发现包含草药和/或天然提取物与合成药物的关联。
    结论:从这个角度来看,还开发了新的药物管理系统,这可能是获得治疗孕妇的新药的有希望的来源;然而,研究仍然有限,并且显示在刺激改善孕妇健康的安全药物的快速开发方面存在差距。
    BACKGROUND: During pregnancy, the woman\'s body undergoes anatomical and physiological changes, making this period susceptible to maternal-fetal diseases and complications. The consequences of not treating pregnant women include premature birth, low birth weight fetuses, and postnatal behavior disorders. Developing new therapies can accelerate the discovery of safe and effective drugs, contributing to designing novel natural and synthetic products to treat complications the pregnancy.
    OBJECTIVE: This study aimed to carry out a patent review to identify and explore trends in innovation and therapeutic strategies for treating pregnant women.
    METHODS: The Espacenet and WIPO databases were used, with the inclusion criteria being the keywords \"pregnancy and drug\" and code A61k, from 2008 to 2023, and as exclusion were the access to the patent and focus on human pregnant women.
    RESULTS: After the final screening, 32 patents were selected, with strategies for the treatment of diseases in pregnant women. Of these, 20 patents are on preclinical studies on animals and 12 on pregnant women. It was observed that universities lead the ranking of applications (17/32), and China has the highest number of patents (18/32). Most findings contain herbal medicines and/or the association of natural extracts with synthetic drugs.
    CONCLUSIONS: From this perspective, new drug administration systems were also developed, which can be a promising source for obtaining new medicines for the treatment of pregnant women; however, research is still limited and shows a gap in stimulating the rapid development of safe drugs that improve the health of pregnant women.
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  • 文章类型: Journal Article
    冠状动脉疾病(CAD)是全球死亡率和残疾调整寿命年(DALYs)损失的最常见原因。这项研究旨在通过对潜在基因和变体的药物基因组学影响的生物信息学分析的系统评价,提出用于治疗CAD的新基因列表。
    PubMed搜索在2020-2023年期间按标题过滤,包括冠状动脉疾病。为了找到对CAD具有药物遗传学影响的基因,根据变体注释考虑了额外的过滤。蛋白质-蛋白质相互作用(PPIs)基因-miRNA相互作用(GMIs),蛋白质-药物相互作用(PDIs)和由STRING-MODEL(ver.12),Cytoscape(ver.3.10),miRTargetLink.2.,NetworkAnalyst(Ver0.3.0),和PharmGKB。
    结果显示5618种出版物,1290篇论文合格,最后,共纳入650篇论文。提取了4608个蛋白质编码基因,其中,区分了1432个独特基因,并保留了530个基于证据的重复基因。71个基因在至少(完全6331个注释)中显示药物遗传学相关变体注释。变体注释评估(VAA)显示最终报告的532个潜在变体,最后,结论PG列表代表175个变体。根据功能和MAF,29个药物基因组学相关基因的57个非同义变异与CAD相关。
    最后,评估患有CAD的个体血浆中的循环miR33a,rs2230806,rs2230808,rs2487032,rs12003906,rs2472507,rs2515629和rs4149297(ABCA1变体)的基因分型导致精确地处方众所周知的药物。此外,本综述的研究结果可用于CAD的预后和诊断的全基因组测序(WGS)和全外显子组测序(WES)分析.
    UNASSIGNED: Coronary artery disease (CAD) is the most common reason for mortality and disability-adjusted life years (DALYs) lost globally. This study aimed to suggest a new gene list for the treatment of CAD by a systematic review of bioinformatics analyses of pharmacogenomics impacts of potential genes and variants.
    UNASSIGNED: PubMed search was filtered by the title including Coronary Artery Disease during 2020-2023. To find the genes with pharmacogenetic impact on the CAD, additional filtrations were considered according to the variant annotations. Protein-Protein Interactions (PPIs), Gene-miRNA Interactions (GMIs), Protein-Drug Interactions (PDIs), and variant annotation assessments (VAAs) performed by STRING-MODEL (ver. 12), Cytoscape (ver. 3.10), miRTargetLink.2., NetworkAnalyst (ver 0.3.0), and PharmGKB.
    UNASSIGNED: Results revealed 5618 publications, 1290 papers were qualified, and finally, 650 papers were included. 4608 protein-coding genes were extracted, among them, 1432 unique genes were distinguished and 530 evidence-based repeated genes remained. 71 genes showed a pharmacogenetics-related variant annotation in at least (entirely 6331 annotations). Variant annotation assessment (VAA) showed 532 potential variants for the final report, and finally, the concluding PGs list represented 175 variants. Based on the function and MAF, 57 nonsynonymous variants of 29 Pharmacogenomics-related genes were associated with CAD.
    UNASSIGNED: Conclusively, evaluating circulating miR33a in individuals\' plasma with CAD, and genotyping of rs2230806, rs2230808, rs2487032, rs12003906, rs2472507, rs2515629, and rs4149297 (ABCA1 variants) lead to precisely prescribing of well-known drugs. Also, the findings of this review can be used in both whole-genome sequencing (WGS) and whole-exome sequencing (WES) analysis in the prognosis and diagnosis of CAD.
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  • 文章类型: Journal Article
    轴位异常(PA)是常见的,高度残疾,以及影响帕金森病(PD)或非典型帕金森病患者的药物难治性运动并发症。在过去的几年里,在诊断方面已经取得了进展,评估,PA的病理生理机制。尽管如此,他们的管理仍然是一个挑战,这些干扰通常被医疗保健专业人员忽视,可能导致他们的恶化和对残疾患者的影响。根据共同的基于共识的评估和诊断标准,PA呼吁基于复杂性和多因素发病机制的跨学科管理。在这种情况下,我们进行了系统的文献综述,根据帕金森病中轴性PA的新专家分类,分析了PD中PA可用的药理学和非药理学治疗方案.不同的多学科方法,包括多巴胺能治疗调整,物理治疗,肉毒杆菌毒素注射,和深部脑刺激,可以根据其类型和严重程度改善PA。很早,建议在PD患者中采用跨学科方法来管理PA。
    Axial postural abnormalities (PA) are frequent, highly disabling, and drug-refractory motor complications affecting patients with Parkinson\'s disease (PD) or atypical parkinsonism. Over the past few years, advances have been reached across diagnosis, assessment, and pathophysiological mechanisms of PA. Nonetheless, their management remains a challenge, and these disturbances are generally overlooked by healthcare professionals, potentially resulting in their worsening and impact on patients\' disabilities. From shared consensus-based assessment and diagnostic criteria, PA calls for interdisciplinary management based on the complexity and multifactorial pathogenesis. In this context, we conducted a systematic literature review to analyze the available pharmacological and non-pharmacological treatment options for PA in PD according to the new expert-based classification of axial PA in Parkinsonism. Different multidisciplinary approaches, including dopaminergic therapy adjustment, physiotherapy, botulinum toxin injection, and deep brain stimulation, can improve PA depending on its type and severity. An early, interdisciplinary approach is recommended in PD patients to manage PA.
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  • 文章类型: Journal Article
    吸毒仍然是世界上尚未解决的最复杂的社会问题之一。在马来西亚,据报道,滥用各种类型的药物,这使政府有必要立即采取管理吸毒者的策略。尽管实施了各种治疗药物成瘾的策略,统计数据显示,多年来复发的数量继续飙升。这要求紧急关注提高马来西亚药物滥用治疗服务的有效性。此外,新出现的证据表明,滥用药物类型的趋势发生了变化。这一因素可能会导致药物滥用治疗策略的无效。因此,这篇综述概述了马来西亚通常滥用的主要药物类型.此外,为了寻求提高药物滥用治疗服务有效性的方法,我们确定了马来西亚负责管理吸毒者的公共机构,并讨论了这些机构提供的治疗方案.审查结果支持需要对这些治疗计划的有效性进行未来研究,并建议实施基于证据的计划,以提高马来西亚药物滥用治疗的有效性。
    Drug addiction remains one of the most complex social problems worldwide that has yet to be resolved. In Malaysia, abuse of various types of drugs has been reported which warrants the government to take immediate strategies in managing drug addicts. Despite implementing various strategies to treat drug addiction, statistics show the number of relapses continues to skyrocket over the years. This calls for urgent attention to improve the effectiveness of substance abuse treatment services in Malaysia. Moreover, emerging evidence shows a change in trend in the type of drug being abused. This factor could potentially contribute to the ineffectiveness of the strategies employed in the treatment of substance abuse. Therefore, this review provides an overview of the major types of drugs commonly abused in Malaysia. Additionally, in an effort to search for ways to improve the effectiveness of substance abuse treatment services, we identified the public institutions responsible for managing drug addicts in Malaysia and discussed the therapeutic programs offered at the institutions. Review findings support the need for future research on the effectiveness of these therapeutic programs and recommend the implementation of evidence-based programs to improve the effectiveness of substance abuse treatments in Malaysia.
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  • 文章类型: Systematic Review
    背景:人际创伤是导致各种不良心理健康结果的危险因素,包括物质使用。研究已经开始调查羞耻在物质使用和人际创伤之间的交集中的作用。当前的系统综述总结了现有文献中记录羞耻之间关系的文献,物质使用,和人际创伤。
    方法:使用与人际关系创伤相关的术语的布尔搜索策略收集文章,物质使用,和六个数据库的耻辱。由三名研究人员进行独立搜索和筛选,最终审查了27篇文章,其中15项为定性研究。
    结果:研究结果强调了羞耻,人际暴力,和不同样本的物质使用。研究结果强调,羞耻感增加与人际暴力幸存者中更多的物质使用有关,鉴于流行率很高,使用物质的个人中存在羞耻感和更大的人际暴力。新兴的研究表明,羞耻调解了人际暴力与物质使用之间的关系。
    结论:我们的综述结果表明,对于出现物质使用和人际暴力史的个体,羞耻可能是一个重要的治疗目标。未来的研究,纵向设计,需要解析羞耻之间的时间关系,物质使用,人际暴力。
    BACKGROUND: Interpersonal trauma is a risk factor for a wide array of adverse mental health outcomes, including substance use. Research has begun investigating the role of shame in the intersection between substance use and interpersonal trauma. The current systematic review summarizes the existing literature documenting the relation among shame, substance use, and interpersonal trauma.
    METHODS: Articles were collected using a Boolean search strategy of terms related to interpersonal trauma, substance use, and shame across six databases. Independent search and screening by three researchers led to a final review of 27 articles, 15 of which were qualitative studies.
    RESULTS: Findings highlight robust associations among shame, interpersonal violence, and substance use across varied samples. Findings emphasize that increased shame is associated with greater substance use among survivors of interpersonal violence and elevated shame and greater interpersonal violence are present among individuals who use substances given the high prevalence rates. Burgeoning research suggests that shame mediates the relationship between interpersonal violence and substance use.
    CONCLUSIONS: Results from our review suggest that shame may be an important treatment target for individuals presenting with substance use and a history of interpersonal violence. Future studies, with longitudinal designs, are needed to parse out the temporal relation among shame, substance use, and interpersonal violence.
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