Medicina
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Even though many industrially manufactured medicines are available, extemporaneous preparations still have their niche in dermatology. In several countries, dermatovenerologists are one of the specialists prescribing extemporaneous medicines the most. In order to increase the quality of compounded medications and minimize risks to patient safety, several countries, for example, Germany and the United States of America (USA), created standardized compounded preparation monographs. Latvia, unlike these countries, does not have any officially approved standardized compounded preparation monographs. The purpose of this survey is to analyze the extemporaneous prescriptions prescribed by Latvian dermatovenerologists to identify the active ingredients, combinations of active ingredients, and excipients prescribed by dermatovenerologists the most often, and to find out how many active ingredients are most often compounded in different dosage forms. To understand whether the extemporaneous formulations used in Latvia for dermatological indications are evidence-based, they were compared with German and USA formulations. ⋯ The analyzed prescriptions contained active ingredients used in Germany and the USA, as well as active ingredients, the use of which is limited in Germany and the USA. In Latvia, topical dosage forms containing two or more active ingredients are widely prescribed.
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Background and Objectives: Distal symmetrical polyneuropathy (DSPN) is one of the most common chronic complications of diabetes mellitus. Although it is usually characterized by progressive sensory loss, some patients may develop chronic pain. Assessment of DSPN is not difficult, but the biggest challenge is making the correct diagnosis and choosing the right treatment. ⋯ While potentially effective in the treatment of neuropathic pain, opioids are not considered to be the first choice because of adverse reactions and addiction concerns. Conclusions: DSPN is a common complication in patients with diabetes, and severely affects the quality of life of these patients. Although multiple therapies are available, the guidelines and recommendations regarding the treatment of diabetic neuropathy have failed to offer a unitary consensus, which often hinders the therapeutic options in clinical practice.
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Review
Challenges and Opportunities in Preclinical Research of Synthetic Cannabinoids for Pain Therapy.
Cannabis has been used in pain management since 2900 BC. In the 20th century, synthetic cannabinoids began to emerge, thus opening the way for improved efficacy. The search for new forms of synthetic cannabinoids continues and, as such, the aim of this review is to provide a comprehensive tool for the research and development of this promising class of drugs. ⋯ In the second part of this review, pharmacokinetic and pharmacodynamic studies of synthetic cannabinoid biodistribution, together with liquid chromatography-mass spectrometric identification of synthetic cannabinoids in biological fluids from rodents to humans are presented. Last, but not least, different strategies for improving the solubility and physicochemical stability of synthetic cannabinoids and their potential impact on pain management are discussed. In conclusion, synthetic cannabinoids are one of the most promising classes of drugs in pain medicine, and preclinical research should focus on identifying new and improved alternatives for a better clinical and preclinical outcome.
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Background and Objectives: Inflammation is considered a risk factor for venous thromboembolism. The association between inflammatory markers and the severity of acute pulmonary embolism (APE) has not been explored. Methods: We studied the association between two crude markers of inflammation, serum albumin, and red cell distribution width (RDW) and massive versus non-massive APE. ⋯ After adjustment for patients' age, body mass index, white blood cell count, the requirement of antibiotics during hospitalization, diabetes, RDW, and peak creatinine, serum albumin was independently associated with massive APE (OR 0.234, 95% CI 0.129-0.4242, P < 0.001). Conclusion: low serum albumin is associated with massive APE. This association is likely a proxy for higher inflammatory state in massive compared with non-massive APE.
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Background and objectives: T-cadherin (T-cad) is one of the adiponectin receptors abundantly expressed in the heart and blood vessels. Experimental studies show that T-cad sequesters adiponectin in cardiovascular tissues and is critical for adiponectin-mediated cardio-protection. However, there are no data connecting cardiac T-cad levels with human chronic heart failure (HF). ⋯ However, decreased T-cad levels in human myocardium can be an additional indicator of HF severity. T-cad in human myocardium has an anti-inflammatory role. More studies are needed to extend the role of T-cad in the outcome prediction of patients with NI-DCM.