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Rational use of medicine

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https://www.readbyqxmd.com/read/28333241/dysmorphic-patterns-are-associated-with-cytoskeletal-alterations-in-human-oocytes
#1
Mariabeatrice Dal Canto, Maria Cristina Guglielmo, Mario Mignini Renzini, Rubens Fadini, Clarissa Moutier, Maria Merola, Elena De Ponti, Giovanni Coticchio
Study Question: Are specific morphological anomalies in human mature oocytes, as revealed by transmitted light microscopy, associated with intrinsic damage to the meiotic spindle and actin cytoskeleton? SUMMARY ANSWER: Aggregates of smooth endoplasmic reticulum (SER) and domains of centrally localized granular cytoplasm (GC) reflect intrinsic damage to the oocyte cytoskeleton, namely alterations in spindle size, chromosome misalignment and cortical actin disorganization...
March 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333136/targeting-3-phosphoinositide-dependent-protein-kinase-1-associated-with-drug-resistant-renal-cell-carcinoma-using-new-oridonin-analogs
#2
Jiancheng Zhou, Eun-Jin Yun, Wei Chen, Ye Ding, Kaijie Wu, Bin Wang, Chunyong Ding, Elizabeth Hernandez, John Santoyo, Rey-Chen Pong, Haiying Chen, Dalin He, Jia Zhou, Jer-Tsong Hsieh
The current agents used for renal cell carcinoma (RCC) only exhibit the moderate response rate among patients. Development of drug resistance eventually fuels the need of either more potent drugs or new drugs to target the resistant pathways. Oridonin is a diterpenoid isolated from the Chinese medicinal herb Rabdosia rubescens and has been shown to have antitumor activities in many cancers. We previously developed new synthetic methodologies to modify structurally diversified diterpenoids and designed a series of nitrogen-enriched oridonin analogs...
March 23, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28325179/pain-management-in-horses
#3
REVIEW
Alonso Guedes
There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach to pain assessment, prevention, and management in the equine patient...
April 2017: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/28317245/efficient-discovery-of-quality-control-markers-for-gastrodia-elata-tuber-by-fingerprint-efficacy-relationship-modelling
#4
Mingfang Li, Yuan Du, Long Wang, Lilong Jiang, Xiaodong Ma, Ping Zhou, Ping Li, Huijun Li
INTRODUCTION: Gastrodia elata tuber (GET) has been widely used in China as a famous herbal medicine. However, the quality control markers (QCMs) for GET still need further investigation. OBJECTIVE: To develop a rational strategy based on fingerprint-efficacy relationship modelling to discover the efficacy-related QCMs, using GET as a case study. METHODOLOGY: The high-performance liquid chromatography (HPLC) fingerprints of 13 batches of GET extracts were established and 10 common peaks were structurally characterised by HPLC coupled with quadrupole time-of-flight mass spectrometry (QTOF-MS)...
March 20, 2017: Phytochemical Analysis: PCA
https://www.readbyqxmd.com/read/28315070/mechanisms-of-resistance-in-multiple-myeloma
#5
Athanasios Papadas, Fotis Asimakopoulos
Multiple myeloma (MM) is an incurable hematopoietic cancer that is characterized by malignant plasma cell infiltration of the bone marrow and/or extramedullary sites. Multi-modality approaches including "novel agents," traditional chemotherapy, and/or stem cell transplantation are used in MM therapy. Drug resistance, however, ultimately develops and the disease remains incurable for the vast majority of patients. In this chapter, we review both tumor cell-autonomous and non-autonomous (microenvironment-dependent) mechanisms of drug resistance...
March 18, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28303438/using-health-technology-assessment-to-assess-the-value-of-new-medicines-results-of-a-systematic-review-and-expert-consultation-across-eight-european-countries
#6
Aris Angelis, Ansgar Lange, Panos Kanavos
BACKGROUND: Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. OBJECTIVE: To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment...
March 16, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28302416/plant-parts-substitution-based-approach-as-a-viable-conservation-strategy-for-medicinal-plants-a-case-study-of-premna-latifolia-roxb
#7
Ashish Kumar Jena, Maninder Karan, Karan Vasisht
BACKGROUND: Rapid population growth and catastrophic harvesting methods of wild medicinal plants especially trees, result in the exploitation of natural sources and its management is the need of the hour. Dashamoolarishta is an amalgam of roots of ten plants of a popular Ayurvedic FDC formulation consisting of the root of Premna latifolia Roxb. as one of its ingredients. Presently, their populations like many other trees are under threat due to extensive use of the roots by the herbal drug industry...
March 14, 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/28301695/justifying-clinical-nudges
#8
Moti Gorin, Steven Joffe, Neal Dickert, Scott Halpern
The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably affect people's choices...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28301004/-the-essentiality-and-rationality-of-the-brazilian-national-listing-of-essential-medicines
#9
Sueli Miyuki Yamauti, José Ruben de Alcântara Bonfim, Silvio Barberato-Filho, Luciane Cruz Lopes
One strategy to implement the rational use of medicines is the adoption of an 'essential medicines list'. The objective of this study was to analyze the list of medicines contained in the Brazilian National Relation of Essential Medicines (Rename, 2013) in terms of essentiality and rationality. Essentiality was determined by comparing this list to the 18th Essential Medicines List (EML) published by the World Health Organization (WHO). Drugs which were part of the Brazilian National Relation of Essential Medicines but not included in the EML were assessed using the classification described in La revue Prescrire to detect medications without added therapeutic value...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28300968/-use-of-medicines-before-and-during-pregnancy-prevalence-and-associated-factors
#10
Débora Bomfim Costa, Helena Lutescia Luna Coelho, Djanilson Barbosa Dos Santos
This cross-sectional prospective nested cohort study aimed to assess the prevalence of use of medication before and during pregnancy and associated factors in women in a municipality in the countryside of Bahia State, Brazil. Data were collected with a structured questionnaire applied to pregnant women at their prenatal visits at health units. Prevalence rates for use of medication before and during pregnancy were 52.1% and 84.7%, respectively. The following were associated with use of medication before pregnancy: age ≥ 30 years, non-white skin color, first prenatal visit after the 1st trimester, and economic classes C/D/E...
March 9, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28297583/assessment-of-drug-sensitivity-in-hematopoietic-stem-and-progenitor-cells-from-acute-myelogenous-leukemia-and-myelodysplastic-syndrome-ex-vivo
#11
Katherine L B Knorr, Laura E Finn, B Douglas Smith, Allan D Hess, James M Foran, Judith E Karp, Scott H Kaufmann
Current understanding suggests that malignant stem and progenitor cells must be reduced or eliminated for prolonged remissions in myeloid neoplasms such as acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS). Multicolor flow cytometry has been widely used to distinguish stem and myeloid progenitor cells from other populations in normal and malignant bone marrow. In this study, we present a method for assessing drug sensitivity in MDS and AML patient hematopoietic stem and myeloid progenitor cell populations ex vivo using the investigational Nedd8-activating enzyme inhibitor MLN4924 and standard-of-care agent cytarabine as examples...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28296925/worldwide-trends-in-volume-and-quality-of-published-protocols-of-randomized-controlled-trials
#12
Belle V van Rosmalen, Ingo Alldinger, Kasia P Cieslak, Roos Wennink, Mike Clarke, Usama Ahmed Ali, Marc G H Besselink
INTRODUCTION: Publishing protocols of randomized controlled trials (RCT) facilitates a more detailed description of study rational, design, and related ethical and safety issues, which should promote transparency. Little is known about how the practice of publishing protocols developed over time. Therefore, this study describes the worldwide trends in volume and methodological quality of published RCT protocols. METHODS: A systematic search was performed in PubMed and EMBASE, identifying RCT protocols published over a decade from 1 September 2001...
2017: PloS One
https://www.readbyqxmd.com/read/28289374/discovery-of-compounds-that-positively-modulate-the-high-affinity-choline-transporter
#13
Parul Choudhary, Emma J Armstrong, Csilla C Jorgensen, Mary Piotrowski, Maria Barthmes, Rubben Torella, Sarah E Johnston, Yuya Maruyama, John S Janiszewski, R Ian Storer, Sarah E Skerratt, Caroline L Benn
Cholinergic hypofunction is associated with decreased attention and cognitive deficits in the central nervous system in addition to compromised motor function. Consequently, stimulation of cholinergic neurotransmission is a rational therapeutic approach for the potential treatment of a variety of neurological conditions. High affinity choline uptake (HACU) into acetylcholine (ACh)-synthesizing neurons is critically mediated by the sodium- and pH-dependent high-affinity choline transporter (CHT, encoded by the SLC5A7 gene)...
2017: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/28275946/a-network-meta-analysis-of-clinical-management-strategies-for-treatment-resistant-hypertension-making-optimal-use-of-the-evidence
#14
Peter Makai, Joanna IntHout, Jaap Deinum, Kevin Jenniskens, Gert Jan van der Wilt
BACKGROUND: With the addition of surgical interventions to current medicinal treatments, it is increasingly challenging for clinicians to rationally choose among the various options for treating patients with apparent treatment-resistant hypertension (ATRHTN). This study aims to establish the comparative effectiveness of mineralocorticoid receptor antagonists (MRA), renal denervation (RDN), darusentan and central arteriovenous anastomosis (CAA) for patients with ATRHTN by performing a network meta-analysis...
March 8, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28263849/chemical-profiles-and-pharmacological-activities-of-chang-kang-fang-a-multi-herb-chinese-medicinal-formula-for-treating-irritable-bowel-syndrome
#15
Qian Mao, Lei Shi, Zhi-Gang Wang, Yu-Hui Luo, Yin-Yu Wang, Xue Li, Min Lu, Jian-Min Ju, Jin-Di Xu, Ming Kong, Shan-Shan Zhou, Min-Qin Shen, Song-Lin Li
ETHNOPHARMACOLOGICAL RELEVANCE: Chang-Kang-Fang formula (CKF), a multi-herb traditional Chinese medicinal formula, has been clinically used for treatment of irritable bowel syndrome (IBS). The mechanisms of CKF for treating IBS and the components that are responsible for the activities were still unknown. AIM OF THE STUDY: To investigate the chemical profiles and effects of CKF on IBS model. MATERIALS AND METHODS: The chemical profiles of CKF were investigated by ultra performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q/TOF-MS/MS)...
March 2, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28260280/teaching-rational-prescribing-to-general-practice-registrars-a-guide-for-supervisors
#16
Simon Morgan
BACKGROUND: Pharmaceuticals play an important role in modern day healthcare, and prescribing is a very common activity in Australian general practice. However, there are significant harms associated with medicine use. Vocational training is a critical period in the development of clinical practice patterns for the future general practitioner (GP), including prescribing behaviour. The general practice supervisor, therefore, has a key role to play in educating registrars about rational prescribing...
March 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28259896/the-one-carbon-metabolism-pathway-highlights-therapeutic-targets-for-gastrointestinal-cancer-review
#17
Masamitsu Konno, Ayumu Asai, Koichi Kawamoto, Naohiro Nishida, Taroh Satoh, Yuichiro Doki, Masaki Mori, Hideshi Ishii
After the initial use of anti-folates for treatment of malignancies, folate metabolism has emerged as a rational diagnostic and therapeutic target in gastrointestinal cancer. The one-carbon metabolic pathway, which comprises three critical reactions (i.e., folate and methionine cycles), underlies this effect in conjunction with the trans-sulfuration pathway. Understanding of the one-carbon metabolism pathway has served to unravel the link between the causes and effects of cancer phenotypes leading to several seminal discoveries such as that of diadenosine tri-phosphate hydrolase, microRNAs, 5-FU and, more recently, trifluridine...
February 20, 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28258218/structural-analyses-of-candida-albicans-sterol-14%C3%AE-demethylase-complexed-with-azole-drugs-address-the-molecular-basis-of-azole-mediated-inhibition-of-fungal-sterol-biosynthesis
#18
Tatiana Y Hargrove, Laura Friggeri, Zdzislaw Wawrzak, Aidong Qi, William J Hoekstra, Robert J Schotzinger, John D York, F Peter Guengerich, Galina I Lepesheva
With some advances in modern medicine (such as cancer chemotherapy, broad exposure to antibiotics, and immunosuppression) the incidence of opportunistic fungal pathogens such as Candida albicans has increased. Cases of drug resistance among these pathogens have become more frequent, requiring the development of new drugs and a better understanding of the targeted enzymes. Sterol 14α-demethylase (CYP51) is a cytochrome P450 enzyme required for biosynthesis of sterols in eukaryotic cells and the major target of clinical drugs for managing fungal pathogens, but some of the CYP51 key features important for rational drug design have remained obscure...
March 3, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28256457/rational-use-of-medicines-cost-consideration-way-forward
#19
Nilima A Kshirsagar
No abstract text is available yet for this article.
October 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28250791/pharmacological-basis-for-use-of-selaginella-moellendorffii-in-gouty-arthritis-antihyperuricemic-anti-inflammatory-and-xanthine-oxidase-inhibition
#20
Ping Zhao, Ke-Li Chen, Guo-Li Zhang, Guang-Rui Deng, Juan Li
This study was aimed at evaluating the effects of Selaginella moellendorffii Hieron. (SM) on gouty arthritis and getting an insight of the possible mechanisms. HPLC method was developed for chemical analysis. The paw oedema, the neutrophil accumulation, inflammatory mediators, lipid peroxidation, and histopathological changes of the joints were analyzed in gouty arthritis rat model, and the kidney injury and serum urate were detected in hyperuricemic mice. Pharmacokinetic result demonstrated that the main apigenin glycosides might be quantitatively transformed into apigenin in the mammalian body...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
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