Comparative effect of aspirin versus clopidogrel monotherapy on incident type 2 diabetes in patients with atherosclerotic cardiovascular diseases: A target trial emulation study.

Aims: To compare the effects of low-dose aspirin and clopidogrel on the risk of incident type 2 diabetes among patients with ASCVD.

Methods: This target trial emulation study was performed usingthe IQVIA Medical Research Data UK primary care database, including adults with an incident first ASCVD event who initiated low-dose aspirin or clopidogrel between 2004 and 2021. We applied an overlap weighting approach to balance treatment groups.

Association of plasma metabolites and cardiac mitochondrial function with heart failure progression.

Aims: Plasma metabolites are prognostic in heart failure with reduced ejection fraction (HFrEF), with citric acid cycle metabolites linked to ejection fraction (EF) changes. We investigated these mechanisms in a canine chronic HFrEF model. We tested associations between changes in plasma metabolites, left ventricular (LV) end-diastolic volume and cardiomyocyte mitochondrial function.

The Impact of Once Daily Dosing on Protein Binding of Clozapine and Norclozapine.

Purpose/background: Clozapine and norclozapine are highly protein bound. Currently, clozapine is increasingly prescribed once daily (QD). Higher (once daily) doses may theoretically lead to saturation of protein binding of (nor)clozapine, resulting in increased unbound fractions.

Clinical features, treatment, and prognosis of nivolumab induced immune encephalitis.

Immune encephalitis (IE) is an immune-mediated adverse events (irAEs) linked to nivolumab therapy, and its clinical characteristics remain unclear. This study aimed to analyze the clinical patterns of nivolumab-induced IE to inform diagnosis, treatment, and prevention strategies. We conducted a retrospective analysis of nivolumab-induced IE by reviewing case reports from the database until October 31, 2024.

Strengths, weaknesses, opportunities, and threats analysis of combination therapy for inflammatory bowel disease.

Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, manifests as a chronic, recurrent, and refractory intestinal inflammatory condition significantly impacting patients' quality of life. Despite ongoing research, its etiology and pathogenesis remain incompletely understood. Recent advancements in medical research highlight the critical role of drug combination therapies in managing IBD.

Diagnostic difficulty in an adolescent with dissociative identity disorder.

Introduction: Dissociative identity disorder (DID) is a complex and controversial psychiatric condition characterised by the presence of two or more distinct identities, personality states, or identities that recurrently take control of an individual's behaviour. The identities or personality states may have distinct characteristics, memories, and behaviours, making identifying and differentiating them challenging. We describe a complex case that presented diagnostic challenges because of the fluctuations in psychiatric presentations associated with DID, and we outline a multidisciplinary and biopsychosocial intervention.

Disposal Practices of Leftover Medicines Among University of Rwanda Undergraduate Students.

Background: University students typically use prescribed or non-prescribed medications, often resulting in the accumulation of leftover medications. Hence, understanding their disposal practices is crucial, as improper disposal contribute to significant public health and environmental risks.

Objective: This study intended to assess the disposal practices of leftover medications among undergraduate students at the University of Rwanda, as well as the factors influencing these practices.

Carbapenem de-escalation as an antimicrobial stewardship strategy: a narrative review.

Increased carbapenem prescribing has contributed to rising rates of carbapenem-resistant bacterial pathogens. Although antimicrobial stewardship efforts that facilitate de-escalation of carbapenems to alternative agents can minimize unnecessary exposure, clinicians may be hesitant to de-escalate therapy due to concerns for potentially compromising patient outcomes. A literature search was performed to characterize carbapenem de-escalation strategies and assess associated patient outcomes.

Calciprotein particle-induced calcium overload triggers mitochondrial dysfunction in endothelial cells.

Calciprotein particles (CPPs) are calcium- and phosphate-containing nanoparticles numbers of which are increased in patients with chronic kidney disease (CKD). CPPs have been associated with the development of vascular disease, although the underlying mechanisms are unknown. We previously showed that CPPs induce endothelial cell (EC) dysfunction by reducing nitric oxide (NO) bioavailability and generating superoxide (O ).

Schisandrol A mitigated voriconazole-induced liver injury in mice through regulation of farnesoid X receptor-mediated bile acid metabolism.

Schisandrol A has been previously used to mitigate hepatotoxicity. However, the effects of schisandrol A on voriconazole-induced hepatic injury have not been investigated. In this study, we aimed to explore the effects of schisandrol A on voriconazole-induced hepatic injury in mice, as well as to elucidate the underlying mechanism.

Plasma esketamine and noresketamine levels and antidepressant response with oral esketamine treatment.

Objective: Oral esketamine has relatively low and variable bioavailability, which may complicate broader use as an antidepressant. This study aimed to investigate associations between different pharmacokinetic outcomes and change in depressive symptoms following oral esketamine administration in patients with treatment-resistant depression. Understanding such associations may inform dosing and administration strategies in clinical practice.

Dietary patterns in Tanzania's transitioning rural and urban areas.

Background: Like other Sub-Saharan Africa (SSA) countries, Tanzania is undergoing socio-economic changes that impact lifestyles and dietary choices. Traditionally, differences in dietary habits between rural and urban areas in Tanzania and other SSA countries were prominent. However, recent research indicates converging lifestyles and dietary choices associated with increased risk of cardiometabolic diseases.

Design and Evaluation of ACAFiB-APP, a clinical decision support system for anticoagulant considerations in patients with atrial fibrillation.

Background: Patients with atrial fibrillation are at risk for various complications, including thromboembolic events. This study involves developing and evaluating a Clinical Decision Support System (CDSS) to select appropriate anticoagulant drug, considering comorbidities, laboratory data, and concurrent medications. The system is based on a streamlined interpretation of the most recent globally accepted clinical guidelines.

Ultrafast cell-free DNA extraction from body fluids using UiO-66-NH hydrogel packed syringe.

Liquid biopsy represents a noninvasive or minimally invasive diagnostic approach relevant for both the organ-specific changes and systemic health conditions, whereas cell-free DNA (cfDNA) extraction from body liquids has attracted much attention in liquid biopsy, especially. Nowadays, metal-organic frameworks (MOF) such as UiO-66-NH has been demonstrated efficient extraction property for DNA molecular, whereas the disadvantages of MOF for solid-phase extraction (SPE) still remain. Herein, one macro-pored MOF hydrogel formation strategy was constructed in this study to achieve superb extraction performance of cfDNAs from body fluids.

Defining histamine H2 receptor antagonist response in critically ill patients with heart failure: a machine learning cluster analysis.

Background: Recent studies showed histamine H2 receptor antagonists (H2RAs) exposure was associated with reduced mortality in heart failure (HF) patients. However, specific HF patients who are sensitive to H2RAs exposure or not are yet to be further defined.

Aim: This study aimed to identify HF patient characteristics that may benefit from H2RAs exposure.

The feasibility of using real world data as external control arms in oncology trials.

Before real world data (RWD)-derived external control arms (ECAs) can be applied in clinical trials within the field of oncology, it must be determined whether these ECAs can function as appropriate and reliable control arms. This review provides an overview of studies in which RWD-derived ECAs were constructed and compared to a randomized clinical trial (RCT) arm. RWD-derived ECAs had similar survival outcomes as the RCT arm of comparison in six of the eight included studies.

Sodium-glucose cotransporter 2 inhibitors in the treatment of heart failure patients: A systematic review and meta-analysis of cost-utility studies.

Aims: Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) have shown promise in reducing cardiovascular mortality and hospitalization due to heart failure (HF), a significant global health issue. This study aims to evaluate the incremental net benefit (INB) of SGLT-2i in HF patients through a systematic review and meta-analysis of cost-utility studies.

Methods: We searched five databases from their inception until Aug 30, 2024, economic evolution studies reporting cost-effectiveness and cost-utility analyses comparing SGLT-2i combined with standard triple-therapy versus standard triple-therapy alone in HF patients were selected.

Rationale and design of the Renal Lifecycle Trial assessing the Effect of Dapagliflozin on Cardiorenal Outcomes in Severe Chronic Kidney Disease.

Background: Several clinical trials have shown beneficial effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on kidney disease progression and cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) with and without type 2 diabetes mellitus. However, some subgroups of patients with CKD have been excluded from participation in these trials, such as patients with severely impaired kidney function, patients on dialysis, and kidney transplant recipients.

Methods: The Renal Lifecycle trial (NCT05374291) is a pragmatic, international, multicenter, investigator-initiated, randomized, placebo-controlled, clinical trial planned to enroll approximately 1500 patients with 1) an estimated glomerular filtration rate (eGFR) ≤25 ml/min/1.

A comprehensive evaluation of Naftifine's efficacy and safety in treating dermatophyte infections; systematic review and meta-analysis.

Dermatophyte infections, including tinea pedis (athlete's foot), tinea corporis (ringworm), and tinea cruris (jock itch), are widespread fungal infections that significantly impact global health and quality of life. Naftifine, an allylamine antifungal agent, is noted for its potent fungicidal activity, targeting fungal cell membranes by inhibiting squalene epoxidase. Additionally, Naftifine has anti-inflammatory and antibacterial properties, enhancing its therapeutic potential.

The effect of colchicine on coagulation in patients with chronic coronary disease who use vitamin K antagonists.

Background: Low-dose (0.5 mg/day) colchicine improves cardiovascular outcomes in patients with stable coronary disease. Around 10-15% of these patients simultaneously use anticoagulant therapy, including vitamin-K antagonists (VKAs).

Knowledge and Attitude of Iraqi Pharmacists Regarding the Adverse Effects of NSAIDs Based on Years of Experience.

Objectives: Informing patients about the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) is essential to ensure their safe use. The aim of this study was to determine whether the years of experience of Iraqi pharmacists affect their knowledge of the renal and gastrointestinal adverse effects of NSAIDs, and their attitudes toward informing patients about drug safety.

Materials And Methods: An online cross-sectional survey was conducted between January and October 2023.

Involvement of SIRT1-mediated aging in liver diseases.

Liver disease is a significant global health issue, responsible for millions of deaths annually. Aging, characterized by the gradual decline in cellular and physiological functions, impairs tissue regeneration, increases susceptibility to liver diseases, and leads to a decline in liver health. Silent information regulator 1 (SIRT1), a NAD⁺-dependent deacetylase, has emerged as a pivotal factor in modulating age-related changes in the liver.

Effect of hypoalbuminemia on drug pharmacokinetics.

Hypoalbuminemia, defined as serum albumin levels below 35 g/L, is common in patients with conditions such as nephrotic syndrome, cirrhosis, or sepsis. This review examines the impact of hypoalbuminemia on the pharmacokinetics of selected drugs-such as antibiotics, immunosuppressants, antifungals, or anticonvulsants-emphasizing its role in drug efficacy and safety. Albumin is the main drug transporter and key binding protein, which influences the free drug concentration and drug activity.

Evaluation of Novel Combined CBC-Derived Systemic Inflammatory Ratios and Their Dynamic Changes as ICU Mortality Predictors, a Retrospective Cohort.

Background And Aims: Novel biomarkers, such as neutrophil lymphocyte ratio, monocyte lymphocyte ratio, neutrophil to lymphocyte platelet ratio, derived neutrophil to lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and aggregate index of systemic inflammation, have shown promising prognostic value, especially in ICU settings. We aimed to evaluate the potential of the mentioned factors as ICU mortality predictors in a heterogeneous ICU cohort.

Methods And Materials: We conducted a retrospective cohort study using data obtained from the intensive care unit (ICU) records of 311 patients.

Application of the random forest algorithm to predict skilled birth attendance and identify determinants among reproductive-age women in 27 Sub-Saharan African countries; machine learning analysis.

Introduction: Maternal mortality refers to a mother's death owing to complications arising from childbirth or pregnancy. This issue is a forefront public health challenge around the globe which is pronounced in low- and middle-income countries, particularly in the sub-Saharan African regions where the burdens remain significantly high. Moreover, this problem is further complicated in developing countries due to limited access to antenatal care and the shortage of skilled birth attendants.