This randomized controlled trial investigated whether early administration of a single high dose of 540,000 IU of vitamin D3 would reduce 90-day mortality in critically ill patients with vitamin D deficiency. 1360 patients screened vitamin D deficient and underwent randomization to receive either vitamin D3 or placebo within 12 hours of ICU admission. 1078 patients had baseline vitamin D deficiency (<20 ng/mL) confirmed by liquid chromatography-tandem mass spectrometry and comprised the primary analysis population. The trial found no significant difference in 90-day mortality between those receiving vitamin D3 (23.5%) versus placebo (20.6%), and no differences in other clinical or safety outcomes.
1. This study examined outcomes of 2541 hospitalized COVID-19 patients treated with hydroxychloroquine alone, hydroxychloroquine plus azithromycin, azithromycin alone, or neither drug.
2. Overall in-hospital mortality was 18.1%. Mortality was lowest in the hydroxychloroquine alone group (13.5%) and highest in the neither drug group (26.4%).
3. After controlling for risk factors, treatment with hydroxychloroquine alone or with azithromycin was associated with reduced COVID-19 mortality compared to no treatment. Prospective randomized trials are still needed.
Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
This article is a preprint and has not been peer-reviewed.
Twitter: @MattisVollan
Improving Adherence in HIV Treatment with Once-Daily TherapiesDocKretschmar
1. Several studies examined the relationship between adherence to antiretroviral drug regimens and virologic outcomes in HIV/AIDS patients. Simpler once-daily dosing was associated with improved adherence and clinical outcomes compared to more complex twice-daily regimens.
2. Other research showed that once-daily dosing of hypertension and diabetes medications led to better adherence rates and health outcomes over twice-daily administration.
3. The data supported transitioning select HIV-infected patients with undetectable viral loads on a twice-daily protease inhibitor regimen to a simplified once-daily regimen, which maintained viral suppression and improved CD4 counts in the majority of patients.
Duchenne Muscular Dystrophy Drugs face Tough Path to ApprovalVikram Rao
Both BioMarin's Kyndrisa and Sarepta's eteplirsen, which aim to treat Duchenne muscular dystrophy through exon-skipping, recently received negative FDA reviews for their NDAs. While BioMarin is working with the FDA on a potential approval pathway for Kyndrisa following its complete response letter, Sarepta's NDA review for eteplirsen was extended to May 2016 after the company submitted additional 4-year clinical effectiveness data. The exon-skipping oligonucleotide therapeutics still have challenges to overcome before they may be approved as the first disease-modifying drugs for Duchenne muscular dystrophy, as the FDA reviews raised concerns about their
This randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of the antiviral remdesivir in 1062 hospitalized adults with COVID-19 and evidence of lower respiratory tract infection. Patients received either intravenous remdesivir (200 mg loading dose on day 1, then 100 mg daily for up to 9 more days) or placebo for up to 10 days. The primary outcome was time to recovery, defined as hospital discharge or hospitalization for non-infectious reasons only. Patients who received remdesivir had a median recovery time of 10 days compared to 15 days for placebo patients, and were more likely to have clinical improvement at day 15. Mortality by day 29 was 11.4% for rem
HIV Alert:Emerging Updates on Dual Therapy.2018hivlifeinfo
In this downloadable slideset, Joseph J. Eron, Jr., MD, and Babafemi Taiwo, MBBS, provide expert insight into the use of a recently-approved dual-therapy regimen and review data surrounding investigational two-drug regimens.
Format: Microsoft PowerPoint (.ppt)
File size: 375 KB
Date posted: 1/5/2018
Necessity of COVID-19 vaccination in previously infected individualsMattisHallsteinVolla
This study examined the incidence of COVID-19 among 52,238 employees in an American healthcare system over 5 months. The study found:
1) The cumulative incidence of COVID-19 remained almost zero among those previously infected who remained unvaccinated, those previously infected who were vaccinated, and those not previously infected who were vaccinated.
2) In contrast, there was a steady increase in cumulative incidence among those not previously infected who remained unvaccinated.
3) Not one of the 1,359 previously infected subjects who remained unvaccinated had COVID-19 over the duration of the study.
The results suggest individuals who have had COVID-19 are unlikely to benefit from vaccination, and vaccines
These 2012 recommendations update the 2008 American College of Rheumatology guidelines for treating rheumatoid arthritis. The updates include: expanded indications for disease-modifying antirheumatic drugs and biologic agents; guidance on switching between therapies; screening patients starting biologics for tuberculosis reactivation; and use of biologics in patients with hepatitis, congestive heart failure, or malignancy. The recommendations aim to provide guidance for clinicians based on the latest evidence.
1. This study examined outcomes of 2541 hospitalized COVID-19 patients treated with hydroxychloroquine alone, hydroxychloroquine plus azithromycin, azithromycin alone, or neither drug.
2. Overall in-hospital mortality was 18.1%. Mortality was lowest in the hydroxychloroquine alone group (13.5%) and highest in the neither drug group (26.4%).
3. After controlling for risk factors, treatment with hydroxychloroquine alone or with azithromycin was associated with reduced COVID-19 mortality compared to no treatment. Prospective randomized trials are still needed.
Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
This article is a preprint and has not been peer-reviewed.
Twitter: @MattisVollan
Improving Adherence in HIV Treatment with Once-Daily TherapiesDocKretschmar
1. Several studies examined the relationship between adherence to antiretroviral drug regimens and virologic outcomes in HIV/AIDS patients. Simpler once-daily dosing was associated with improved adherence and clinical outcomes compared to more complex twice-daily regimens.
2. Other research showed that once-daily dosing of hypertension and diabetes medications led to better adherence rates and health outcomes over twice-daily administration.
3. The data supported transitioning select HIV-infected patients with undetectable viral loads on a twice-daily protease inhibitor regimen to a simplified once-daily regimen, which maintained viral suppression and improved CD4 counts in the majority of patients.
Duchenne Muscular Dystrophy Drugs face Tough Path to ApprovalVikram Rao
Both BioMarin's Kyndrisa and Sarepta's eteplirsen, which aim to treat Duchenne muscular dystrophy through exon-skipping, recently received negative FDA reviews for their NDAs. While BioMarin is working with the FDA on a potential approval pathway for Kyndrisa following its complete response letter, Sarepta's NDA review for eteplirsen was extended to May 2016 after the company submitted additional 4-year clinical effectiveness data. The exon-skipping oligonucleotide therapeutics still have challenges to overcome before they may be approved as the first disease-modifying drugs for Duchenne muscular dystrophy, as the FDA reviews raised concerns about their
This randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of the antiviral remdesivir in 1062 hospitalized adults with COVID-19 and evidence of lower respiratory tract infection. Patients received either intravenous remdesivir (200 mg loading dose on day 1, then 100 mg daily for up to 9 more days) or placebo for up to 10 days. The primary outcome was time to recovery, defined as hospital discharge or hospitalization for non-infectious reasons only. Patients who received remdesivir had a median recovery time of 10 days compared to 15 days for placebo patients, and were more likely to have clinical improvement at day 15. Mortality by day 29 was 11.4% for rem
HIV Alert:Emerging Updates on Dual Therapy.2018hivlifeinfo
In this downloadable slideset, Joseph J. Eron, Jr., MD, and Babafemi Taiwo, MBBS, provide expert insight into the use of a recently-approved dual-therapy regimen and review data surrounding investigational two-drug regimens.
Format: Microsoft PowerPoint (.ppt)
File size: 375 KB
Date posted: 1/5/2018
Necessity of COVID-19 vaccination in previously infected individualsMattisHallsteinVolla
This study examined the incidence of COVID-19 among 52,238 employees in an American healthcare system over 5 months. The study found:
1) The cumulative incidence of COVID-19 remained almost zero among those previously infected who remained unvaccinated, those previously infected who were vaccinated, and those not previously infected who were vaccinated.
2) In contrast, there was a steady increase in cumulative incidence among those not previously infected who remained unvaccinated.
3) Not one of the 1,359 previously infected subjects who remained unvaccinated had COVID-19 over the duration of the study.
The results suggest individuals who have had COVID-19 are unlikely to benefit from vaccination, and vaccines
These 2012 recommendations update the 2008 American College of Rheumatology guidelines for treating rheumatoid arthritis. The updates include: expanded indications for disease-modifying antirheumatic drugs and biologic agents; guidance on switching between therapies; screening patients starting biologics for tuberculosis reactivation; and use of biologics in patients with hepatitis, congestive heart failure, or malignancy. The recommendations aim to provide guidance for clinicians based on the latest evidence.
These 2012 recommendations update the 2008 American College of Rheumatology guidelines for treating rheumatoid arthritis. The updates include: expanding the list of recommended biologic agents; providing more guidance on switching between DMARD and biologic therapies; addressing use of biologic agents in patients with hepatitis, congestive heart failure, or malignancy; updating tuberculosis screening recommendations for patients starting biologics; and adding information on new vaccinations. The recommendations were developed by reviewing evidence and forming consensus opinions among experts in rheumatology and evidence-based medicine.
Harshitha B, Subhada B, Mustafa M, Solanki H, Safiya NA, Tiwari RV. DNA laddering to evaluate cytogenetic damage in patients with periodontitis. J Int Soc Prevent Communit Dent 2019;9:486-91.
Prevention of adverse drug events in hospitalsantoshbhskr
Dr. Santosh Kumar Bhaskar discusses prevention of adverse drug events in hospitals. A 55-year-old man with liver and kidney issues was admitted for diarrhea and decreased urine output. His condition initially improved with treatment but then deteriorated, with decreasing urine output and worsening liver tests. The doctor considers whether an infectious cause could be resistant to treatment, the patient's liver decompensated, or the treatment plan needs review. Adverse drug events are common in hospitals and increase costs. Prevention requires both provider-based strategies like reviewing high-risk medications and systems-based approaches like computerized order entry and pharmacist interventions.
Coles alemtuzumab camm223 10yr efficacy safety aan 2016_poster p3.053BartsMSBlog
Alemtuzumab demonstrated durable efficacy and a consistent safety profile over 10 years in patients with relapsing-remitting multiple sclerosis (RRMS) from the CAMMS223 study. Most patients maintained a low annualized relapse rate and experienced stabilization or improvement in disability scores. While adverse events were most common in the first year, serious safety issues were rare, with infections declining over time and no deaths occurring. Alemtuzumab provided sustained benefit for RRMS with limited additional treatment for many patients over 10 years.
This study aimed to identify risk factors associated with longer stays in the cardiovascular surgical intensive care unit (ICU) after coronary artery bypass grafting (CABG) using the Donabedian model. The study found that potential signs of infection like higher white blood cell count and temperature, and acute renal failure were the most significant predictors of staying longer than 3 days in the ICU. Additional risk factors included female gender, smoking history, higher Charlson Comorbidity Index before surgery, use of cardiopulmonary bypass during CABG, and higher Therapeutic Intervention Scoring System score within 24 hours of ICU admission. The study concluded that quality improvement initiatives to shorten ICU stay after CABG should focus on better managing infection control
The CLARITY Challenge aimed to develop standards for clinical genome sequencing by having groups analyze whole exome and genome sequencing data from three families with genetic disorders. 30 international groups participated. Their analyses showed convergence in bioinformatics techniques but diversity in medical interpretation and reporting, demonstrating these areas require further standardization. Only two groups identified the consensus candidate variants in all cases, showing methods need fine-tuning. The Challenge assessed current practices and their ability to diagnose genetic diseases from sequencing data.
This study evaluated the effectiveness of Ivermectin in treating COVID-19. It analyzed data from over 1,400 patients across 3 continents, comparing outcomes of patients who received Ivermectin to matched controls. It found lower mortality in the Ivermectin group (1.4% vs 8.5%), with a hazard ratio of 0.20. For patients requiring ventilation, mortality was also lower in the Ivermectin group (7.3% vs 21.3%). The study concludes Ivermectin is associated with improved survival in COVID-19 and randomized controlled trials are needed to confirm this.
This study compared remission rates in 5,848 rheumatoid arthritis patients from 24 countries using different definitions of remission. The overall remission rate varied substantially depending on the definition used, from 8.6% using the ACR definition to 19.6% using DAS28. Remission rates also varied considerably between countries. Regardless of the definition, factors associated with higher remission rates included male sex, higher education, shorter disease duration, fewer comorbidities, and regular exercise. The results indicate that reported remission rates need to be interpreted based on the specific definition of remission that was applied.
This study analyzed genetic sequences of HIV-1 subtype C tat and env genes from blood samples of 155 HIV-infected patients in India who underwent neuropsychological testing. Around 36% of patients showed neurocognitive impairment. Two signature residues were identified in tat exon 1 that were associated with impairment - arginine at codon 29 and proline at codon 68. Positive selection was seen at these codons in both impaired and normal groups. The signatures were also linked to lower CD4+ counts but remained associated with impairment after excluding those with low CD4+. No unique signatures were found in env. This supports a link between diversifying selection in subtype C tat and neurocognitive impairment in this population.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
Early Hydroxychloroquine but not Chloroquine use reduces ICU admission in COV...La Verità
1) An observational study of 1064 COVID-19 patients in Dutch hospitals found that early treatment with hydroxychloroquine (HCQ) on the first day of admission was associated with a 53% reduced risk of transfer to the intensive care unit (ICU) for mechanical ventilation, compared to untreated patients.
2) No significant effect was found of HCQ or chloroquine (CQ) treatment on mortality for patients on the COVID-19 ward.
3) The protective effect against ICU transfer was seen for HCQ but not for CQ, indicating these drugs cannot be considered interchangeable for COVID-19 treatment.
Gene therapy using an AAV vector was tested in 6 males with severe hemophilia B. The vector encoded Factor IX and was administered via peripheral vein infusion. No safety issues were found regarding germline transmission or formation of antibodies against FIX. Mild, transient elevations in liver enzymes occurred in some subjects. FIX levels increased in a dose-dependent manner, allowing 4 subjects to stop prophylactic FIX treatment without bleeding. While the study demonstrated proof-of-concept for hemophilia B gene therapy, larger trials are needed to further evaluate safety and efficacy.
This document summarizes findings from a retrospective study of 97 patients with metastatic renal cell carcinoma treated with high-dose interleukin-2 (HD IL-2) between 2007-2012. It found that one, two, and three year survival rates were 86%, 66%, and 62% respectively, with an overall median survival of 50.9 months. Patients who had stable or responsive disease survived longer than those with progressive disease. Having a good performance status and normal LDH levels were associated with better outcomes. The results suggest HD IL-2 may provide long-term clinical benefit, especially as first-line therapy, and validate improved survival compared to pre-targeted therapy studies. Larger prospective studies are still needed to validate these findings.
Vitamin D And Chronic Periodontitis – A Randomised Double Blinded Placebo Con...inventionjournals
Background: Vitamin D is crucial for a wide variety of organ systems; nevertheless, evidence has demonstrated that vitamin D deficiency may place subjects at risk for not only low mineral bone density /osteoporosis and osteopenia but also infectious and chronic inflammatory diseases Vitamin D also has anti-inflammatory effects by suppressing pro-inflammatory cytokines through its effect on bone and mineral metabolism, innate immunity and several VDR gene polymorphisms, vitamin D has been reported to be associated with periodontal disease. Objectives: To assess anti-inflammatory effect of vitamin D3, when administered as monotherapy in generalised chronic periodontitis. Methods: This study comprises of 56 patients of generalised chronic periodontitis who were screened for their serum vitamin D3 levels. Out of which 30 patients who were vitamin D3 deficient (<20ng /><0.002)><0.000). Conclusion: Vitamin D deficiency may place subjects at risk for not only low bone mineral density/osteoporosis and osteopenia, but also infectious and chronic inflammatory diseases like periodontitis.
- The LEADERS FREE trial compared outcomes of patients at high risk of bleeding who received either a polymer-free drug-coated stent releasing umirolimus (BioFreedom stent) or a bare-metal stent, both with 1 month of dual antiplatelet therapy.
- Use of the drug-coated stent was associated with lower rates of the primary safety composite of cardiac death, MI, or stent thrombosis and the primary efficacy endpoint of clinically-driven TLR compared to the bare-metal stent.
- The drug-coated stent showed benefit over the bare-metal stent in reducing rates of MI, likely driven by lower rates of in-stent restenosis, without increasing the risk of bleeding which
Low-dose hydroxychloroquine therapy and mortality in hospitalised patients wi...La Verità
This study analyzed data from a nationwide surveillance of 8075 COVID-19 patients hospitalized in Belgium to compare in-hospital mortality between those treated with low-dose hydroxychloroquine (HCQ) monotherapy (2400 mg total over 5 days) and supportive care only. The HCQ-treated group had lower mortality (17.7% vs 27.1%). In a statistical analysis adjusting for demographic and clinical factors, HCQ treatment was independently associated with lower mortality compared to supportive care alone. Subgroup analyses found reduced mortality with HCQ for patients diagnosed both within 5 days and over 5 days from symptom onset.
1) The study found that filaggrin (FLG) gene mutations are common in white patients with severe atopic dermatitis in the United States, with 48.5% of patients carrying a mutation. Compound heterozygous and homozygous mutations were found in 18.8% of patients.
2) Patients with homozygous or compound heterozygous FLG mutations had significantly higher serum immunoglobulin E levels than patients with heterozygous or wild-type FLG genes.
3) Screening for additional FLG mutations beyond the two most common identified more mutations than previous studies, showing the genetic basis of severe atopic dermatitis is more complex than previously understood.
This systematic review and meta-analysis of individual participant data from 25 randomized controlled trials involving over 10,000 participants found that:
1) Vitamin D supplementation reduced the risk of acute respiratory tract infections overall, with an adjusted odds ratio of 0.88.
2) The protective effect was stronger in participants who received daily or weekly vitamin D without additional bolus doses, with an adjusted odds ratio of 0.81.
3) Among participants receiving daily or weekly vitamin D, protective effects were strongest in those with severely low baseline 25-hydroxyvitamin D levels (<25 nmol/L), with an adjusted odds ratio of 0.30, compared to 0.75 in those with higher baseline levels.
The document summarizes evidence on preventing falls in older adults through vitamin D supplementation. It finds that vitamin D supplementation reduces falls by 13-23% and that higher doses (700-1000 IU) achieving serum levels over 24 ng/mL and active forms of vitamin D are most effective. A meta-analysis of randomized controlled trials found vitamin D significantly reduced falls, especially in those getting sufficient vitamin D or using active forms. Risk factors for falls like impairments in balance, vision and strength can be addressed through vitamin D supplementation.
Современное лечение ВИЧ: лечение многократно леченных пациентов с резистентно...hivlifeinfo
This document discusses management of HIV in heavily treatment-experienced patients with multiclass resistance and limited treatment options. It provides an overview of the problem, including that some older patients were treated early in the HIV epidemic with less potent regimens, resulting in resistance. Younger patients may have congenital HIV and been treated long-term. Assessment of virologic failure and resistance testing are important to select an effective new regimen. Current options for active drugs in these patients include maraviroc, ibalizumab, fostemsavir, and enfuvirtide, which have novel mechanisms of action. Adherence assessment is also critical to determine if the current regimen may still be effective if taken as prescribed.
These 2012 recommendations update the 2008 American College of Rheumatology guidelines for treating rheumatoid arthritis. The updates include: expanding the list of recommended biologic agents; providing more guidance on switching between DMARD and biologic therapies; addressing use of biologic agents in patients with hepatitis, congestive heart failure, or malignancy; updating tuberculosis screening recommendations for patients starting biologics; and adding information on new vaccinations. The recommendations were developed by reviewing evidence and forming consensus opinions among experts in rheumatology and evidence-based medicine.
Harshitha B, Subhada B, Mustafa M, Solanki H, Safiya NA, Tiwari RV. DNA laddering to evaluate cytogenetic damage in patients with periodontitis. J Int Soc Prevent Communit Dent 2019;9:486-91.
Prevention of adverse drug events in hospitalsantoshbhskr
Dr. Santosh Kumar Bhaskar discusses prevention of adverse drug events in hospitals. A 55-year-old man with liver and kidney issues was admitted for diarrhea and decreased urine output. His condition initially improved with treatment but then deteriorated, with decreasing urine output and worsening liver tests. The doctor considers whether an infectious cause could be resistant to treatment, the patient's liver decompensated, or the treatment plan needs review. Adverse drug events are common in hospitals and increase costs. Prevention requires both provider-based strategies like reviewing high-risk medications and systems-based approaches like computerized order entry and pharmacist interventions.
Coles alemtuzumab camm223 10yr efficacy safety aan 2016_poster p3.053BartsMSBlog
Alemtuzumab demonstrated durable efficacy and a consistent safety profile over 10 years in patients with relapsing-remitting multiple sclerosis (RRMS) from the CAMMS223 study. Most patients maintained a low annualized relapse rate and experienced stabilization or improvement in disability scores. While adverse events were most common in the first year, serious safety issues were rare, with infections declining over time and no deaths occurring. Alemtuzumab provided sustained benefit for RRMS with limited additional treatment for many patients over 10 years.
This study aimed to identify risk factors associated with longer stays in the cardiovascular surgical intensive care unit (ICU) after coronary artery bypass grafting (CABG) using the Donabedian model. The study found that potential signs of infection like higher white blood cell count and temperature, and acute renal failure were the most significant predictors of staying longer than 3 days in the ICU. Additional risk factors included female gender, smoking history, higher Charlson Comorbidity Index before surgery, use of cardiopulmonary bypass during CABG, and higher Therapeutic Intervention Scoring System score within 24 hours of ICU admission. The study concluded that quality improvement initiatives to shorten ICU stay after CABG should focus on better managing infection control
The CLARITY Challenge aimed to develop standards for clinical genome sequencing by having groups analyze whole exome and genome sequencing data from three families with genetic disorders. 30 international groups participated. Their analyses showed convergence in bioinformatics techniques but diversity in medical interpretation and reporting, demonstrating these areas require further standardization. Only two groups identified the consensus candidate variants in all cases, showing methods need fine-tuning. The Challenge assessed current practices and their ability to diagnose genetic diseases from sequencing data.
This study evaluated the effectiveness of Ivermectin in treating COVID-19. It analyzed data from over 1,400 patients across 3 continents, comparing outcomes of patients who received Ivermectin to matched controls. It found lower mortality in the Ivermectin group (1.4% vs 8.5%), with a hazard ratio of 0.20. For patients requiring ventilation, mortality was also lower in the Ivermectin group (7.3% vs 21.3%). The study concludes Ivermectin is associated with improved survival in COVID-19 and randomized controlled trials are needed to confirm this.
This study compared remission rates in 5,848 rheumatoid arthritis patients from 24 countries using different definitions of remission. The overall remission rate varied substantially depending on the definition used, from 8.6% using the ACR definition to 19.6% using DAS28. Remission rates also varied considerably between countries. Regardless of the definition, factors associated with higher remission rates included male sex, higher education, shorter disease duration, fewer comorbidities, and regular exercise. The results indicate that reported remission rates need to be interpreted based on the specific definition of remission that was applied.
This study analyzed genetic sequences of HIV-1 subtype C tat and env genes from blood samples of 155 HIV-infected patients in India who underwent neuropsychological testing. Around 36% of patients showed neurocognitive impairment. Two signature residues were identified in tat exon 1 that were associated with impairment - arginine at codon 29 and proline at codon 68. Positive selection was seen at these codons in both impaired and normal groups. The signatures were also linked to lower CD4+ counts but remained associated with impairment after excluding those with low CD4+. No unique signatures were found in env. This supports a link between diversifying selection in subtype C tat and neurocognitive impairment in this population.
A Possible Role of Rosmarinic Acid against CD2 Associated Protein for the Tre...YogeshIJTSRD
Multiple sclerosis is a chronic inflammatory neurodegenerative disorder which directly affects Central Nervous System CNS . People with MS suffer with an episodic reversible memory loss during the initial stages and later it leads to the neurological deterioration. Number of research and studies has been done on the natural compounds and phytochemical compounds in order to develop the particular drug for the treatment of MS in vivo andin vitro. The present study focuses on the inhibitory effect of Rosmarinic acid against the effect of CD2 Associated protein with the help of Molecular Docking. Molecular Docking basically screens the ligand and the target protein and shows the interaction between them on the basis of the minimum binding affinities and drug likeliness properties. In our research, docking was performed between CD2 Associated protein and selected ligands with the help of docking software. Ligands were selected on the basis of their minimum Binding affinities and finally by their drug likeliness properties. Rosmarinic acid BA 5.6 was the resultant ligand of our recent study. It showed the perfect interaction with CD2 Associated protein. Therefore, we may conclude that Rosmarinic acid may act as a compound which may be used as a drug for the treatment of multiple sclerosis fromfurther in vitro and in vivostudies in future. Jitin Kumar | Tejaswee Anand | Ritika Sharma | Noopur Khare | Abhimanyu Kumar Jha | Yamini Dixit "A Possible Role of Rosmarinic Acid against CD2-Associated Protein for the Treatment of Multiple Sclerosis through in Silico Approach" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd44979.pdf Paper URL: https://www.ijtsrd.com/biological-science/biotechnology/44979/a-possible-role-of-rosmarinic-acid-against-cd2associated-protein-for-the-treatment-of-multiple-sclerosis-through-in-silico-approach/jitin-kumar
Early Hydroxychloroquine but not Chloroquine use reduces ICU admission in COV...La Verità
1) An observational study of 1064 COVID-19 patients in Dutch hospitals found that early treatment with hydroxychloroquine (HCQ) on the first day of admission was associated with a 53% reduced risk of transfer to the intensive care unit (ICU) for mechanical ventilation, compared to untreated patients.
2) No significant effect was found of HCQ or chloroquine (CQ) treatment on mortality for patients on the COVID-19 ward.
3) The protective effect against ICU transfer was seen for HCQ but not for CQ, indicating these drugs cannot be considered interchangeable for COVID-19 treatment.
Gene therapy using an AAV vector was tested in 6 males with severe hemophilia B. The vector encoded Factor IX and was administered via peripheral vein infusion. No safety issues were found regarding germline transmission or formation of antibodies against FIX. Mild, transient elevations in liver enzymes occurred in some subjects. FIX levels increased in a dose-dependent manner, allowing 4 subjects to stop prophylactic FIX treatment without bleeding. While the study demonstrated proof-of-concept for hemophilia B gene therapy, larger trials are needed to further evaluate safety and efficacy.
This document summarizes findings from a retrospective study of 97 patients with metastatic renal cell carcinoma treated with high-dose interleukin-2 (HD IL-2) between 2007-2012. It found that one, two, and three year survival rates were 86%, 66%, and 62% respectively, with an overall median survival of 50.9 months. Patients who had stable or responsive disease survived longer than those with progressive disease. Having a good performance status and normal LDH levels were associated with better outcomes. The results suggest HD IL-2 may provide long-term clinical benefit, especially as first-line therapy, and validate improved survival compared to pre-targeted therapy studies. Larger prospective studies are still needed to validate these findings.
Vitamin D And Chronic Periodontitis – A Randomised Double Blinded Placebo Con...inventionjournals
Background: Vitamin D is crucial for a wide variety of organ systems; nevertheless, evidence has demonstrated that vitamin D deficiency may place subjects at risk for not only low mineral bone density /osteoporosis and osteopenia but also infectious and chronic inflammatory diseases Vitamin D also has anti-inflammatory effects by suppressing pro-inflammatory cytokines through its effect on bone and mineral metabolism, innate immunity and several VDR gene polymorphisms, vitamin D has been reported to be associated with periodontal disease. Objectives: To assess anti-inflammatory effect of vitamin D3, when administered as monotherapy in generalised chronic periodontitis. Methods: This study comprises of 56 patients of generalised chronic periodontitis who were screened for their serum vitamin D3 levels. Out of which 30 patients who were vitamin D3 deficient (<20ng /><0.002)><0.000). Conclusion: Vitamin D deficiency may place subjects at risk for not only low bone mineral density/osteoporosis and osteopenia, but also infectious and chronic inflammatory diseases like periodontitis.
- The LEADERS FREE trial compared outcomes of patients at high risk of bleeding who received either a polymer-free drug-coated stent releasing umirolimus (BioFreedom stent) or a bare-metal stent, both with 1 month of dual antiplatelet therapy.
- Use of the drug-coated stent was associated with lower rates of the primary safety composite of cardiac death, MI, or stent thrombosis and the primary efficacy endpoint of clinically-driven TLR compared to the bare-metal stent.
- The drug-coated stent showed benefit over the bare-metal stent in reducing rates of MI, likely driven by lower rates of in-stent restenosis, without increasing the risk of bleeding which
Low-dose hydroxychloroquine therapy and mortality in hospitalised patients wi...La Verità
This study analyzed data from a nationwide surveillance of 8075 COVID-19 patients hospitalized in Belgium to compare in-hospital mortality between those treated with low-dose hydroxychloroquine (HCQ) monotherapy (2400 mg total over 5 days) and supportive care only. The HCQ-treated group had lower mortality (17.7% vs 27.1%). In a statistical analysis adjusting for demographic and clinical factors, HCQ treatment was independently associated with lower mortality compared to supportive care alone. Subgroup analyses found reduced mortality with HCQ for patients diagnosed both within 5 days and over 5 days from symptom onset.
1) The study found that filaggrin (FLG) gene mutations are common in white patients with severe atopic dermatitis in the United States, with 48.5% of patients carrying a mutation. Compound heterozygous and homozygous mutations were found in 18.8% of patients.
2) Patients with homozygous or compound heterozygous FLG mutations had significantly higher serum immunoglobulin E levels than patients with heterozygous or wild-type FLG genes.
3) Screening for additional FLG mutations beyond the two most common identified more mutations than previous studies, showing the genetic basis of severe atopic dermatitis is more complex than previously understood.
This systematic review and meta-analysis of individual participant data from 25 randomized controlled trials involving over 10,000 participants found that:
1) Vitamin D supplementation reduced the risk of acute respiratory tract infections overall, with an adjusted odds ratio of 0.88.
2) The protective effect was stronger in participants who received daily or weekly vitamin D without additional bolus doses, with an adjusted odds ratio of 0.81.
3) Among participants receiving daily or weekly vitamin D, protective effects were strongest in those with severely low baseline 25-hydroxyvitamin D levels (<25 nmol/L), with an adjusted odds ratio of 0.30, compared to 0.75 in those with higher baseline levels.
The document summarizes evidence on preventing falls in older adults through vitamin D supplementation. It finds that vitamin D supplementation reduces falls by 13-23% and that higher doses (700-1000 IU) achieving serum levels over 24 ng/mL and active forms of vitamin D are most effective. A meta-analysis of randomized controlled trials found vitamin D significantly reduced falls, especially in those getting sufficient vitamin D or using active forms. Risk factors for falls like impairments in balance, vision and strength can be addressed through vitamin D supplementation.
Современное лечение ВИЧ: лечение многократно леченных пациентов с резистентно...hivlifeinfo
This document discusses management of HIV in heavily treatment-experienced patients with multiclass resistance and limited treatment options. It provides an overview of the problem, including that some older patients were treated early in the HIV epidemic with less potent regimens, resulting in resistance. Younger patients may have congenital HIV and been treated long-term. Assessment of virologic failure and resistance testing are important to select an effective new regimen. Current options for active drugs in these patients include maraviroc, ibalizumab, fostemsavir, and enfuvirtide, which have novel mechanisms of action. Adherence assessment is also critical to determine if the current regimen may still be effective if taken as prescribed.
Vitamin D supplementation in type 2 diabetes patients with pulmonary tuberculosis may lead to earlier sputum smear conversion. In a study of 30 patients with both conditions and vitamin D deficiency, those receiving weekly vitamin D and daily calcium (group 1) showed smear conversion after 6 weeks on average, versus 8 weeks for the non-supplemented group. While the difference was not statistically significant, vitamin D appeared to provide a trend toward faster clinical improvement when added to standard antituberculosis treatment. Larger studies are needed to validate if vitamin D deficiency screening and supplementation could benefit similar patients.
This document summarizes clinical data from 53 patients with severe Covid-19 who were treated with the investigational antiviral remdesivir through a compassionate use program. Key findings include:
- 68% (36 patients) showed improvement in oxygen support needs, including 57% of those on mechanical ventilation being extubated.
- 47% (25 patients) were discharged from the hospital, and 13% (7 patients) died, with a higher mortality among those receiving invasive ventilation.
- Remdesivir appeared to have a favorable safety profile based on previous experience in Ebola patients, though efficacy will need to be determined through ongoing randomized controlled trials.
Delamanid for multidrug resistant pulmonary tuberculosisHaroon Rashid
Delamanid is a new drug that inhibits mycolic acid synthesis in Mycobacterium tuberculosis. This randomized controlled trial evaluated the safety and efficacy of Delamanid (100 mg or 200 mg twice daily) plus background regimen compared to placebo plus background regimen in 481 patients with multidrug-resistant pulmonary tuberculosis over 2 months. Patients receiving Delamanid had higher rates of sputum culture conversion at 2 months compared to placebo, indicating Delamanid enhances treatment options for multidrug-resistant tuberculosis. However, the short 2-month treatment period was a limitation.
1) The study evaluated a smartphone app aimed at improving medication adherence and lifestyle changes in myocardial infarction patients. 174 patients were randomized to either an interactive app (active group) or a simplified app (control group) in addition to usual post-MI care.
2) The primary outcome was a composite score of ticagrelor adherence based on missed doses and treatment gaps, measured via patient-registered data in the app. Secondary outcomes included changes in cardiovascular risk factors, quality of life, and patient satisfaction.
3) At 6 months, greater ticagrelor adherence was achieved in the active group compared to the control group based on the adherence score. The active group also showed trends toward improved smoking cessation, physical
This study compared characteristics, outcomes, and cytokine responses in solid organ transplant recipients and non-transplant patients with bacteremia. Transplant patients with gram-negative bacteremia had a lower rate of septic shock but similar 30-day mortality compared to non-transplant patients. Five cytokines were significantly lower in transplant patients, while one cytokine was higher in transplant patients with Staphylococcus aureus bacteremia. The study aims to better understand how immunosuppression impacts the immune response and outcomes of bacteremia in transplant recipients.
This randomized controlled trial involved 5037 critically ill patients admitted to ICUs in Australia and New Zealand who were assigned to receive either a balanced multielectrolyte solution (BMES, Plasma-Lyte 148) or 0.9% saline as their intravenous fluid for up to 90 days. The primary outcome was all-cause mortality within 90 days. There was no significant difference in 90-day mortality between the BMES group (21.8%) and the saline group (22.0%). Secondary outcomes including acute kidney injury, measured by new renal replacement therapy or changes in creatinine, also did not differ significantly between the groups. The trial found no evidence that using BMES instead of saline improved outcomes for
Vitamin D plays an important role in many body systems beyond bone health. The document discusses Vitamin D's role in cardiovascular health and diabetes mellitus. It summarizes that Vitamin D deficiency is associated with hypertension possibly through effects on the renin-angiotensin system and vascular endothelium. Deficiency is also linked to insulin resistance and type 2 diabetes, likely through direct and indirect molecular mechanisms involving pancreatic beta cell function, insulin signaling, and calcium regulation. Studies show high rates of Vitamin D deficiency in patients with diabetes and hypertension. Oral supplementation improves related outcomes such as vascular function and oxidative stress.
The Health Innovation Network Polypharmacy programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications.
Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Identifying Orthostatic Hypotension caused by Medication, can be viewed here.
For more information about the polypharmacy programme, please visit https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/
Early phase drug development and the fda roadmap final version 2axE. Dennis Bashaw
This is the slide deck used in my webinar that was presented on 2/1/2018 on the FDA Predictive Toxicology Roadmap. It was presented at a webinar hosted by BioIVT in my private capacity and is not an official statement of FDA policy
Austin Biometrics and Biostatistics is a peer-reviewed, open access journal published by Austin Publishers. It provides easy access to high quality Manuscripts covering wide aspects of science of biostatistics that encompasses the design of biological experiments in various related fields like medicine, pharmacy, agriculture and fishery where the collection, summarization, and analysis of data, interpretations of data and inference. This journal also focuses upon the combination of biology and statistics, commonly referred as Biometry or Biometrics.
Austin Publishing Group is a successful host of more than hundred peer reviewed, open access journals in various fields of science and technology with intent to bridge the gap between academia and research access.
Austin Biometrics and Biostatistics accepts original research articles, review articles, case reports, mini reviews, rapid communication, opinions and editorials on all the related aspects of biometrics and biostatistics.
A cohort study evaluated the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on older COVID-19 patients. 17 patients received DMB and 26 did not. Significantly fewer DMB patients required oxygen therapy (17.6% vs 61.5%). DMB exposure was associated with reduced odds of oxygen therapy need and intensive care support. The study supports larger trials to determine if DMB can ameliorate COVID-19 severity through immunomodulation.
This document provides information from the GrassrootsHealth organization regarding vitamin D research and recommendations. It includes the following:
- A summary of several studies showing reductions in disease incidence as vitamin D serum levels increase from 25 ng/ml to higher levels such as 40-60 ng/ml. Diseases such as cancer, diabetes, fractures, and multiple sclerosis showed reductions.
- Charts analyzing data from over 7,000 participants in the GrassrootsHealth D*action project, showing a wide range of serum levels for any given supplemental vitamin D intake amount. Intakes of 4,000 IU/day resulted in serum levels from 10-150 ng/ml.
- Analysis suggesting supplemental intakes of 9,
This document provides guidelines for the diagnosis and treatment of community-acquired pneumonia (CAP) in adults. It addresses 16 specific questions related to diagnostic testing, determining treatment location, selecting initial antibiotic therapy, and ongoing management. While some recommendations remain unchanged from 2007, new evidence has led to revised guidance for empiric treatment strategies and management decisions. The guidelines were developed using the GRADE framework to systematically review evidence and formulate recommendations.
This document provides guidelines for the diagnosis and treatment of community-acquired pneumonia (CAP) in adults. It addresses 16 questions related to diagnostic testing, determining treatment location, selecting initial antibiotic therapy, and ongoing management. While some recommendations remain unchanged from 2007, new evidence has led to revisions for empiric treatment strategies and additional management decisions. The guidelines were developed using the GRADE framework to systematically review evidence and formulate recommendations. Key recommendations include not routinely obtaining sputum cultures for outpatients, but obtaining cultures for hospitalized severe CAP patients or those at risk of drug-resistant pathogens. The guidelines also provide recommendations on initial antibiotic regimens for both outpatients and hospitalized patients with or without risk factors.
This document provides guidelines for the diagnosis, treatment and prevention of Clostridium difficile infections (CDI). It summarizes key recommendations with evidence grading. For diagnosis, it recommends nucleic acid amplification tests over toxin enzyme immunoassays, and only testing diarrheal stool samples. It stratifies treatment based on disease severity into mild-moderate (treat with metronidazole), severe (vancomycin with/without metronidazole), and complicated (vancomycin orally and rectally with intravenous metronidazole). It also covers recurrent CDI treatment, managing CDI in patients with comorbidities, and infection control practices like contact precautions and environmental disinfection. The guidelines
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics