es/iode’s Post

📃Scientific paper: Medium cut-off dialyzer for middle molecular uremic toxins in AKI and chronic dialysis Abstract: Uremic toxins accumulate in patients affected by renal failure and can deposit in different organs, including the kidneys and heart. Given their physicochemical characteristics, uremic toxins can contribute to organ dysfunction due to several pathobiological actions at cellular and molecular levels. Several uremic compounds have been described in serum and plasma from patients with acute kidney injury (AKI) and kidney failure; they are usually classified based on their molecular size and protein-binding properties. In this scenario, new dialytic approaches have been proposed in the last few years with the aim of improving uremic toxin removal. Recent studies which focused on the use of medium cut-off membranes in patients on chronic hemodialysis have shown a discrete ability to remove β2-microglobulin and other middle molecules, such as kappa and lambda free light chains, complement factor D and α1-microglobulin. However, current evidence is mainly based on the impact on short-term outcomes and, consequently, longer observational studies are necessary to confirm the efficacy and safety of the medium cut-off dialyzer. Here we present the state-of-the-art on the clinical application of medium cut-off membranes in AKI and chronic dialysis patients. Graphical abstract Continued on ES/IODE ➡️ https://etcse.fr/S6fb ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

I recently read an important article that provides key insights into the potential disadvantages of using a placebo in randomized trials for the maintenance of remission in inflammatory bowel disease (IBD). The study systematically analyzed data from trials involving biologics and small molecules and highlighted critical risks. 🔑 Here are the key takeaways: 1️⃣ There were no significant differences between active drugs and placebo for overall treatment-emergent adverse events, serious infections, or venous thromboembolic events. 2️⃣ Active drugs showed higher risks of infections (RR: 1.14) and drug-related adverse events (RR: 1.24). 💊 Benefits of Active Drugs: Active treatments were associated with lower risks of worsening IBD activity (RR: 0.58), serious adverse events (RR: 0.85), and withdrawals due to adverse events (RR: 0.71). ✳️ Placebo Risks: Placebo use was linked with clinically meaningful harms, especially an increased risk of worsening IBD activity, highlighting the need for careful patient counseling. 🛣️ My view: ↗️ This article highlights the importance of balancing patient safety with rigorous testing in clinical trials. ↗️ It also encourages exploring alternative trial designs to minimize risks while effectively evaluating new therapies for IBD. #IBD #ClinicalTrials #PatientSafety #Gastroenterology #MetaAnalysis #PharmaResearch #Biologics #EvidenceBasedMedicine

📃Scientific paper: Biosimilar Tenecteplase Versus Alteplase in Acute Ischemic Stroke: A Real World Study Abstract: BACKGROUND AND PURPOSE: There is an unmet need for a more effective thrombolytic agent in acute ischemic stroke (AIS) management. Various studies and meta-analysis suggest tenecteplase (TNK) as non-inferior over alteplase (rTPA). The present single-center study compares biosimilar TNK and rTPA in a tertiary care setting. METHODS: Data of patients who presented with AIS and underwent intravenous thrombolysis (IVT) were recruited retrospectively from January 2018 to July 2021. Primary efficacy outcome was a modified Rankin score (mRS) at 90 days dichotomized at < = 2. Qualitative and quantitative variables were assessed using Chi-square test and Student's t-test, respectively. RESULTS: A total of 160 patients, 103 in the rTPA and 57 in TNK group, were analyzed. The baseline characteristics were well matched apart from hypertension. Large artery atherosclerosis was the most frequent subtype of stroke among the two groups. Good functional outcome was seen in 47.92% of patients TNK and 64.77% of patients in rTPA group (p = 0.069). No difference was seen in the rates of any ICH (p = 0.29) and mortality at 3 months (p = 0.32) among the two groups. CONCLUSION: This present study observed no difference in the efficacy and safety between biosimilar TNK and rTPA. Our findings are in concordance with published trials showing equivalence between the two molecules. Continued on ES/IODE ➡️ https://etcse.fr/WoB ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

📃Scientific paper: Biosimilar Tenecteplase Versus Alteplase in Acute Ischemic Stroke: A Real World Study Abstract: BACKGROUND AND PURPOSE: There is an unmet need for a more effective thrombolytic agent in acute ischemic stroke (AIS) management. Various studies and meta-analysis suggest tenecteplase (TNK) as non-inferior over alteplase (rTPA). The present single-center study compares biosimilar TNK and rTPA in a tertiary care setting. METHODS: Data of patients who presented with AIS and underwent intravenous thrombolysis (IVT) were recruited retrospectively from January 2018 to July 2021. Primary efficacy outcome was a modified Rankin score (mRS) at 90 days dichotomized at < = 2. Qualitative and quantitative variables were assessed using Chi-square test and Student's t-test, respectively. RESULTS: A total of 160 patients, 103 in the rTPA and 57 in TNK group, were analyzed. The baseline characteristics were well matched apart from hypertension. Large artery atherosclerosis was the most frequent subtype of stroke among the two groups. Good functional outcome was seen in 47.92% of patients TNK and 64.77% of patients in rTPA group (p = 0.069). No difference was seen in the rates of any ICH (p = 0.29) and mortality at 3 months (p = 0.32) among the two groups. CONCLUSION: This present study observed no difference in the efficacy and safety between biosimilar TNK and rTPA. Our findings are in concordance with published trials showing equivalence between the two molecules. Continued on ES/IODE ➡️ https://etcse.fr/WoB ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

https://lnkd.in/eci8uDjZ PRECAME Study: Preventing cardiovascular effects with metformin in obese patients ( Corpori Sano Biotechnology & Walter LAB, Brasil 🇧🇷 2002 ): " Specific therapy, to live healthily " " Creating a scientific basis for an infinite possibility of future studies and research " " A new therapeutic approach in cardiovascular, metabolic and oncological prevention " " Scientific research that studies the basis of the iceberg of cardiovascular disease " " Insulin resistance sensitiizers or modulators: Therapeutic link between human metabolism, cardiovascular system and cancer " " Drug that modulates mitochondrial, endothelial and DNA-telomere function " " The era of insulin resistance modulators, ability to alter the cellular regulatory circuit " " Through innovative medicines for public health and commited to bringing better health and a better future for patients, translating science and regenerative medicine into medicines that change human lives, as the main objective " " PRECAME Study and Walter's Metabolic Theory, improving the perspective and quality of life of patients " #science #ciencia #cardiovascular #health #cancer #obesity #diabetes #liverdisease #healthcare #pharmaceutical #clinicaltrials #endocrinology #lifescience #diabetescare #clinicalresearch #cellculture #cardiovascularhealth #cardiology #populationhealth #digitalhealth #hypertension #lipids #cholesterol #innovation #prevention #innovation #industry #industriafarmaceutica #immunology #genetherapy #immunology #regenerativemedicine

💊 Montelukast: A Potential Protector Against Vancomycin-Induced Kidney Injury Vancomycin, a life-saving antibiotic, is widely used in clinical practice, but it comes with a significant downside: acute kidney injury (AKI). New findings suggest that montelukast, a leukotriene receptor antagonist, could play a protective role in mitigating this risk. 📊 Study Insights: 1️⃣ Retrospective Cohort Study - Among 440 patients receiving vancomycin, those who also received montelukast had a significantly lower incidence of AKI (P = 0.01). - AKI was assessed using the RIFLE criteria, a reliable tool for evaluating kidney function. 2️⃣ In Vitro Mechanistic Study - Montelukast demonstrated protective effects on proximal tubule cells by: - Enhancing HO-1 expression, which reduces apoptosis. - Improving cell viability under toxic conditions caused by vancomycin. 🧠 Why This Matters for Healthcare Providers: - AKI can prolong hospitalization, increase healthcare costs, and worsen patient outcomes. - Montelukast, as an adjunct therapy, may offer a simple and cost-effective strategy to minimize this complication. 🔍 Takeaway: Leveraging montelukast could reduce patient harm and enhance the safety profile of vancomycin, potentially transforming how we approach nephrotoxicity in clinical practice. What are your thoughts on integrating such strategies into routine care? Let’s discuss innovative ways to safeguard our patients! 📌 #Nephrology #Pharmacology #AntibioticTherapy #Montelukast #Vancomycin #PatientSafety #AcuteKidneyInjury #HealthcareInnovation #HealthCareProfessionals

📃Scientific paper: Association between oral microbial dysbiosis and poor functional outcomes in stroke-associated pneumonia patients Abstract: Background Despite advances in our understanding of the critical role of the microbiota in stroke patients, the oral microbiome has rarely been reported to be associated with stroke-associated pneumonia (SAP). We sought to profile the oral microbial composition of SAP patients and to determine whether microbiome temporal instability and special taxa are associated with pneumonia progression and functional outcomes. Methods This is a prospective, observational, single-center cohort study that examined patients with acute ischemic stroke (AIS) who were admitted within 24 h of experiencing a stroke event. The patients were divided into three groups based on the occurrence of pneumonia and the use of mechanical ventilation: nonpneumonia group, SAP group, and ventilator-associated pneumonia (VAP) group. We collected oral swabs at different time points post-admission and analyzed the microbiota using 16 S rRNA high-throughput sequencing. The microbiota was then compared among the three groups. Results In total, 104 nonpneumonia, 50 SAP and 10 VAP patients were included in the analysis. We found that SAP and VAP patients exhibited significant dynamic differences in the diversity and composition of the oral microbiota and that the magnitude of this dysbiosis and instability increased during hospitalization. Then, by controlling the potential effect of all latent confounding variables, we assessed the changes associated with pneumonia after stroke and explored patients with ... Continued on ES/IODE ➡️ https://etcse.fr/x5D ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you.

I am thrilled to announce the publication of my latest research article, "Molecular Mechanisms and Therapeutic Potential of Natural Flavonoids in Diabetic Nephropathy: Modulation of Intracellular Developmental Signaling Pathways," in the Q1-ranked *Current Research in Pharmacology and Drug Discovery* journal by Elsevier. This study discusses the intricate subcellular mechanisms underlying the pathogenesis of diabetic nephropathy (DN) and highlights the molecular targets of flavonoids in combating this disease. Our findings underscore the critical need for innovative drug discovery approaches, increased clinical trials, and the therapeutic significance of natural compounds in treating DN. I invite you to explore the open-access article here: https://lnkd.in/dSgXiMYR

📃Scientific paper: Should evidence of an autolysosomal de-acidification defect in Alzheimer and Parkinson diseases call for caution in prescribing chronic PPI and DMARD? Abstract: Nearly fifty million older people suffer from neurodegenerative diseases, including Alzheimer (AD) and Parkinson (PD) disease, a global burden expected to triple by 2050. Such an imminent “neurological pandemic” urges the identification of environmental risk factors that are hopefully avoided to fight the disease. In 2022, strong evidence in mouse models incriminated defective lysosomal acidification and impairment of the autophagy pathway as modifiable risk factors for dementia. To date, the most prescribed lysosomotropic drugs are proton pump inhibitors (PPIs), chloroquine (CQ), and the related hydroxychloroquine (HCQ), which belong to the group of disease-modifying antirheumatic drugs (DMARDs). This commentary aims to open the discussion on the possible mechanisms connecting the long-term prescribing of these drugs to the elderly and the incidence of neurodegenerative diseases. Abbreviations: AD: Alzheimer disease; APP-βCTF: amyloid beta precursor protein-C-terminal fragment; BACE1: beta-secretase 1; BBB: brain blood barrier; CHX: Ca(2+)/H(+) exchanger; CMI: cognitive mild impairment; CQ: chloroquine; DMARD: disease-modifying antirheumatic drugs; GBA1: glucosylceramidase beta 1; HCQ: hydroxychloroquine; HPLC: high-performance liquid chromatography; LAMP: lysosomal associated membrane protein; MAPK/JNK: mitogen-activated protein kinase; MAPT: microtubule associated protein tau; MCOLN1/TRPML1: mucolipin TRP cation channel 1; NFE2L2/NRF2: NFE2 like bZIP transcription f... Continued on ES/IODE ➡️ https://etcse.fr/S3fjT ------- If you find this interesting, feel free to follow, comment and share. We need your help to enhance our visibility, so that our platform continues to serve you. #alzheimer #science #health

✳️ Risks of Placebo in IBD Maintenance Trials Recent findings from a meta-analysis shared an important aspect of clinical trials in inflammatory bowel disease (IBD).  While the efficacy of licensed biologics and small molecules in maintaining remission is well-established, the potential harms associated with placebo treatment during these trials deserve closer observation.⚡  🧠 Key Findings: 💠 This systematic review included 45 trials with 16,562 patients and emphasized that receiving a placebo in maintenance trials is not without risks. 💠 Notably, patients receiving active drugs experienced lower rates of any worsening of IBD activity (12.8% vs. 22.8%), withdrawals due to adverse events (5.9% vs. 9.0%), and serious adverse events (10.4% vs. 12.0%) compared to those on placebo. 💠 Conversely, the risks of any infections and drug-related adverse events were found to be higher in the active drug group.   👉 My View: It's important to balance aiming for effectiveness and considering the ethical aspects of trial design. ↗️ The study's results highlight the importance of transparently communicating with patients about the possible adverse effects of receiving a placebo in clinical trials. ↗️ This also highlights the need for meaningful discussions about creating innovative trial structures that reduce risks while generating reliable data on new treatments. ↗️ By providing that patients receive comprehensive information and support, we can promote a more ethical approach to clinical research that prioritizes patient well-being.⚡ #IBD #ClinicalTrials #InflammatoryBowelDisease #Placebo #PatientSafety #ResearchEthics #HealthcareInnovation