Medicines (Basel, Switzerland)最新文献

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Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety. 替格瑞洛与普拉格雷治疗急性冠脉综合征:现实世界的治疗和安全性。
Medicines (Basel, Switzerland) Pub Date : 2025-05-14 DOI: 10.3390/medicines12020013
Fadel Bahouth, Boris Chutko, Haitham Sholy, Sabreen Hassanain, Gassan Zaid, Evgeny Radzishevsky, Ibrahem Fahmwai, Mahmod Hamoud, Nemer Samnia, Johad Khoury, Idit Dobrecky-Mery
{"title":"Ticagrelor Versus Prasugrel in Acute Coronary Syndrome: Real-World Treatment and Safety.","authors":"Fadel Bahouth, Boris Chutko, Haitham Sholy, Sabreen Hassanain, Gassan Zaid, Evgeny Radzishevsky, Ibrahem Fahmwai, Mahmod Hamoud, Nemer Samnia, Johad Khoury, Idit Dobrecky-Mery","doi":"10.3390/medicines12020013","DOIUrl":"https://doi.org/10.3390/medicines12020013","url":null,"abstract":"<p><p><b>Introduction:</b> A direct head-to-head comparison between potent P2Y12 inhibitors: prasugrel versus ticagrelor is still lacking. <b>Purpose:</b> In this single-center study, we sought to address the efficacy and safety of these two third-generation antiplatelet drugs, after about a decade of practical use. <b>Methods:</b> A retrospective observational study included all patients who were admitted with acute coronary syndrome between January 2010 and December 2019 and were discharged with aspirin and either prasugrel or ticagrelor after percutaneous coronary intervention. Patients were divided into two groups based on the dual antiplatelet drugs prescribed. Primary endpoint: A composite endpoint of cardiovascular death, recurrent coronary syndrome, or ischemic stroke at one year. Secondary endpoint: Significant bleeding according to the BARC classification (types 3, 4, or 5). <b>Results:</b> During this period, 746 patients met the inclusion criteria. The primary endpoint was reached in 70 patients (9.4%): 24 patients (8.0%) in the group treated with ticagrelor and 46 patients (10.3%) in the group treated with prasugrel (<i>p</i>-value = 0.303). In terms of safety events, significant bleeding was not statistically different between the ticagrelor and prasugrel groups: 13 (2.9%) vs. 9 (3%), respectively (<i>p</i>-value = 0.9). More patients discontinued their treatment before the end of the year among those treated with ticagrelor compared to those treated with prasugrel. [16.7% vs. 9.6%, <i>p</i>-value = 0.003). <b>Conclusions:</b> There was no significant difference in the occurrence of recurrent cardiac events, stroke, or cardiovascular death, nor significant bleeding among ACS patients treated either with prasugrel or ticagrelor<b>.</b></p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the Market Readiness for Medical Cannabis in Greece: A Qualitative Study of Patient Perspectives. 评估希腊医用大麻的市场准备情况:病人观点的定性研究。
Medicines (Basel, Switzerland) Pub Date : 2025-05-09 DOI: 10.3390/medicines12020012
Christos Ntais, Yioula Melanthiou
{"title":"Assessing the Market Readiness for Medical Cannabis in Greece: A Qualitative Study of Patient Perspectives.","authors":"Christos Ntais, Yioula Melanthiou","doi":"10.3390/medicines12020012","DOIUrl":"10.3390/medicines12020012","url":null,"abstract":"<p><p><b>Background:</b> The introduction of medical cannabis in Greece marks a shift in healthcare policy, yet patient attitudes remain underexplored. <b>Methods:</b> This qualitative study examines the market readiness for medical cannabis through semi-structured interviews with 24 participants-12 users of cannabidiol (CBD)-based formulations and 12 medical cannabis-naive individuals. <b>Results:</b> CBD-experienced patients generally perceive cannabis-based treatments as beneficial for managing musculoskeletal pain, migraines, anxiety, stress and sleep disturbances, despite concerns over product quality, cost and limited medical guidance. Medical cannabis-naive participants express skepticism due to stigma and perceived insufficient evidence but acknowledge potential therapeutic value within a regulated framework. This study highlights the need for better patient education, physician training and clear regulatory guidelines to support responsible market entry. <b>Conclusions:</b> These findings offer important insights for policymakers, healthcare providers and the pharmaceutical industry, emphasizing the need for a structured, evidence-based approach to medical cannabis integration in Greece. Further research is needed to assess long-term patient experiences and the evolving impact of regulatory changes on market dynamics.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of Healing Potential of Bombyx mori L. (Silkworm) Derivatives on Second-Degree Burns: Dose-Response and Combination Therapy Analysis. 家蚕衍生物对二度烧伤愈合潜力的评价:剂量-反应和联合治疗分析。
Medicines (Basel, Switzerland) Pub Date : 2025-04-30 DOI: 10.3390/medicines12020011
Evrydiki Katsikari, Alexandra Kyriaki, Andreas Vitsos, Margarita Vidali, Paschalis Harizanis, Ioannis Sfiniadakis, Maria Kostaki, Dimitra Ieronymaki, Asimina Terezaki, Georgios Ladopoulos, Chara Albani, Christina Barda, Michail Christou Rallis
{"title":"Assessment of Healing Potential of <i>Bombyx mori</i> L. (Silkworm) Derivatives on Second-Degree Burns: Dose-Response and Combination Therapy Analysis.","authors":"Evrydiki Katsikari, Alexandra Kyriaki, Andreas Vitsos, Margarita Vidali, Paschalis Harizanis, Ioannis Sfiniadakis, Maria Kostaki, Dimitra Ieronymaki, Asimina Terezaki, Georgios Ladopoulos, Chara Albani, Christina Barda, Michail Christou Rallis","doi":"10.3390/medicines12020011","DOIUrl":"10.3390/medicines12020011","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Burn injuries present significant treatment challenges due to the intricate nature of the healing process. <i>Bombyx mori</i> L. (silkworm) derivatives, containing healing-promoting proteins such as sericin and fibroin, as well as the anti-inflammatory enzyme serrapeptase, have shown promise as potential healing agents. This study aimed to identify the optimal dosage of silkworm body and gland extracts for burn healing, compare the selected dose's effectiveness with that of silkworm cocoons, and assess the combined healing effects of a cocoon dressing and a silkworm body extract gel. <b>Methods:</b> An experimental model was employed using hairless SKH-hr2 female mice subjected to standardized second-degree burns. The mice received treatments with various formulations of silkworm body and gland extracts, silkworm cocoons, and a combined application of a cocoon dressing and silkworm body extract gel. <b>Results:</b> The most effective treatments were the cocoon dressing and the combination of cocoon dressing with 60% body extract gel. By Day 20, complete healing (100%) was observed in the 20% and 60% body and gland extract groups, while the cocoon and 60% gland extract groups exhibited 60% healing, significantly higher than the control group (0% healing). Wound contraction analysis showed the greatest reduction in surface area from Day 3 to Day 17 in the cocoon and 60% body extract groups (<i>p</i> < 0.05). Histopathological assessments revealed that the combination group exhibited the least tissue damage (score: 7), compared to the control (score: 10-13). <b>Conclusions:</b> The study highlights the poorly examined therapeutic potential of silkworm body and gland extracts, demonstrating their efficacy in accelerating burn healing. The effects observed by the silkworm cocoon and body extract suggests a novel and promising approach for burn wound management, warranting further clinical exploration.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is the Impact of Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors on Bone Metabolism and Fracture Incidence a Class or Drug Effect? A Narrative Review. 钠-葡萄糖共转运蛋白2 (SGLT2)抑制剂对骨代谢和骨折发生率的影响是一类还是药物效应?叙述性评论。
Medicines (Basel, Switzerland) Pub Date : 2025-04-16 DOI: 10.3390/medicines12020010
George I Lambrou, Athanasia Samartzi, Eugenia Vlachou, Athanasios N Tsartsalis
{"title":"Is the Impact of Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors on Bone Metabolism and Fracture Incidence a Class or Drug Effect? A Narrative Review.","authors":"George I Lambrou, Athanasia Samartzi, Eugenia Vlachou, Athanasios N Tsartsalis","doi":"10.3390/medicines12020010","DOIUrl":"https://doi.org/10.3390/medicines12020010","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Type 2 diabetes mellitus (T2DM) has a growing prevalence, even in developed countries. Because of the increase in life expectancy, the number of older people with T2DM is also increasing. The management and handling of these patients is challenging due to its co-morbidities. <b>Aim</b>: In the present study, we reviewed the literature in order to investigate the impact of sodium-glucose co-transporter 2 inhibitors (SGLT-2 inhibitors) on bone metabolism and fracture incidence. Methods: We searched the literature using the databases of PubMed, CENTRAL and Cochrane Central Register of Controlled Trials up to December 2024. <b>Results</b>: There is a controversial position in the literature concerning the effects of SGLT2 inhibitors when administered in T2DM, with respect to bone metabolism and bone fracture incidence. Multiple studies suggest the SGLT2 inhibitors have a disadvantageous effect on bone metabolism and fracture incidence, while several others suggest a beneficial effect. <b>Conclusions</b>: Patients with type 2 diabetes mellitus are at high risk of alterations in their bone metabolism. SGLT2 inhibitors are a novel class with pleiotropic effects in many organs, such as the kidneys and heart, although their effect on bone metabolism and fracture incidence is still unclear. Until we have more clinical data, all caregivers (medical and nursing staff) should be aware of possible bone fractures in patients receiving this class of agents.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Retrospective Bayesian Reanalysis of Single Gentamicin Concentrations: A Neonatal Case Series. 单一庆大霉素浓度的回顾性贝叶斯再分析:新生儿病例系列。
Medicines (Basel, Switzerland) Pub Date : 2025-04-10 DOI: 10.3390/medicines12020009
Staci L Hemmer, Sarah K Scoular
{"title":"Retrospective Bayesian Reanalysis of Single Gentamicin Concentrations: A Neonatal Case Series.","authors":"Staci L Hemmer, Sarah K Scoular","doi":"10.3390/medicines12020009","DOIUrl":"https://doi.org/10.3390/medicines12020009","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Nomograms for adjusting gentamicin therapy in neonates using a single concentration are limited. The Dersch-Mills nomogram is inefficient for short-duration therapies, while the NeoFax nomogram is outdated based on the current American Academy of Pediatrics (AAP) guidelines. Bayesian software has shown accuracy for vancomycin in adults, but its performance for gentamicin in neonates is unclear. This study evaluates the accuracy of Bayesian estimation in predicting peak and trough gentamicin concentrations from a single measured level in neonates. <b>Methods</b>: A single-center, retrospective re-analysis was conducted of gentamicin concentrations in neonates. InsightRx<sup>®</sup> was used to estimate maximum and minimum concentrations in a dosing interval (Cmax and Cmin) based on a single peak or trough concentration. Bias and accuracy were characterized using the mean difference (MD) between estimated and measured concentrations and the 95% limits of agreement (LOA) for the differences (±1.96 × SD). <b>Results</b>: Fifty-seven neonates (73 peak/trough pairs) were analyzed. Median gestational age was 34 weeks and median postnatal age was 0 days. The MD (LOA) between Cmin estimates and measured troughs was 0.03 mg/L (-0.17 to 0.13) for the trough-only analysis and 0.21 mg/L (-0.38 to 0.8) for the peak-only analysis. The MD (LOA) between Cmax estimates and measured peaks was 0.16 mg/L (-3.2 to 3.3) for the trough-only analysis and 1.2 mg/L (-0.58 to 3.0) for the peak-only analysis. <b>Conclusions</b>: In neonates, a Bayesian analysis of a trough concentration produces reliable Cmin estimates but is not as accurate in estimating Cmax. Analyzing a peak concentration produces Cmax and Cmin values that overestimate true concentrations. If the goal of monitoring is to ensure sufficiently low troughs, a single-level analysis is reasonable if levels are drawn near the end of the dosing interval, but Cmin predictions based on levels drawn early in the dosing interval should be avoided.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyponatraemia Induced by Terlipressin in Patients Diagnosed with Decompensated Liver Cirrhosis and Acute Variceal Bleeding. 特利加压素在肝硬化失代偿伴急性静脉曲张出血患者中的低钠血症。
Medicines (Basel, Switzerland) Pub Date : 2025-03-28 DOI: 10.3390/medicines12020007
Mahmoud Elshehawy, Richel Merin Panicker, Alaa Amr Abdelgawad, Patrick Anthony Ball, Hana Morrissey
{"title":"Hyponatraemia Induced by Terlipressin in Patients Diagnosed with Decompensated Liver Cirrhosis and Acute Variceal Bleeding.","authors":"Mahmoud Elshehawy, Richel Merin Panicker, Alaa Amr Abdelgawad, Patrick Anthony Ball, Hana Morrissey","doi":"10.3390/medicines12020007","DOIUrl":"https://doi.org/10.3390/medicines12020007","url":null,"abstract":"<p><p><b>Background:</b> Hyponatraemia is a rare but potentially life-threatening complication of terlipressin therapy. <b>Case history:</b> In the current case, a 39-year-old female with decompensated liver cirrhosis (Child-Pugh C) and acute variceal bleeding experienced a precipitous decline in serum sodium-from 136 mmol/L to 115 mmol/L-within 48 h of initiating terlipressin therapy. This was accompanied by marked fluid retention, reduced urine output, and symptoms of confusion and agitation. Laboratory tests confirmed dilutional hyponatraemia, characterized by urinary sodium <20 mmol/L and urine osmolality <100 mOsm/kg, indicating excessive free water reabsorption. <b>Outcomes:</b> The prompt discontinuation of terlipressin, fluid restriction and the cautious administration of hypertonic sodium chloride solution (2.7% NaCl) achieved a gradual normalization of sodium levels and resolution of symptoms. Fluid balance monitoring revealed a marked diuretic response following terlipressin cessation. This case aligns with existing reports, emphasizing the dual vasopressin receptor activity of terlipressin and its capacity to induce hyponatraemia, particularly in cirrhotic patients with preserved renal function and higher baseline sodium levels. <b>Conclusions:</b> This case and a literature review underscored the critical need for early fluid balance monitoring to detect retention. This case highlights the importance of individualized risk assessment, multidisciplinary management, and vigilant sodium correction to avoid complications. Practical recommendations are outlined to aid clinicians in the recognition and management of terlipressin-induced hyponatraemia.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Common Bacterial Infections in Persons Who Inject Drugs. 注射吸毒者常见的细菌感染。
Medicines (Basel, Switzerland) Pub Date : 2025-03-28 DOI: 10.3390/medicines12020008
Michael P Lorenzo, Kathleen K Adams, Seth T Housman
{"title":"Common Bacterial Infections in Persons Who Inject Drugs.","authors":"Michael P Lorenzo, Kathleen K Adams, Seth T Housman","doi":"10.3390/medicines12020008","DOIUrl":"https://doi.org/10.3390/medicines12020008","url":null,"abstract":"<p><p>Opioid use in the United States has increased dramatically. Bacterial infections are common among persons who inject drugs (PWID), and there is a disparity in the care these individuals receive. As such, outcomes associated with these infections can be poor. Healthcare providers can address these disparities through optimal pharmacotherapy recommendations and assistance with changing approaches to the management of PWID.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New Synthetic Compounds with Psychoactive Action-Preliminary Results Among Primary and High School Students on the Territory of Novi Sad. 具有精神活性的新型合成化合物——在诺维萨德地区小学生和中学生中的初步结果。
Medicines (Basel, Switzerland) Pub Date : 2025-03-14 DOI: 10.3390/medicines12010006
Igor Kelečević, Ljubica Gugleta, Ana-Marija Vejnović, Vesna Mijatović Jovin
{"title":"New Synthetic Compounds with Psychoactive Action-Preliminary Results Among Primary and High School Students on the Territory of Novi Sad.","authors":"Igor Kelečević, Ljubica Gugleta, Ana-Marija Vejnović, Vesna Mijatović Jovin","doi":"10.3390/medicines12010006","DOIUrl":"10.3390/medicines12010006","url":null,"abstract":"<p><p><b>Introduction:</b> Novel psychoactive substances (NPSs) are substances not controlled by the United Nations' 1961 Narcotic Drugs and 1971 Psychotropic Substances convention, which pose a threat to public health. The use of NPSs is growing among recreational drug users. NPSs mimic the effects of the existing illegal drugs; they are used as substitutes for the traditional drugs of use. NPSs are commonly marketed as safe substances. NPS abuse is especially risky among vulnerable individuals, such as children and adolescents. <b>The Aim:</b> This study aims to analyze the knowledge and attitudes of primary and high school students regarding NPSs, determining the frequency and patterns of NPS use, and examine motivational factors for their consumption. <b>Methodology:</b> The questionnaire was employed to primary and secondary school students of the city of Novi Sad in November 2024. The data were analyzed using the methods of descriptive and inferential statistics in the statistical software package JASP 0.18.1.0. <b>Results:</b> A total of 1095 participants took part in the survey (53.6% males and 46.4% females). The age range of participants was 11-18 years (mean age 14.637 years). The majority of pupils lived in the city (70.5%). The most numerous students were students with the highest overall grade. The proportion of students who were familiar with NPSs was 38.3%, while 61.7% of them were not aware of their existence. Living in cities correlated positively with the NPS knowledge. The NPS risk awareness was notably low. The proportion of students who tried one or more novel drugs was 1.918%. <b>Conclusions:</b> The abuse of novel psychoactive substances is a growing concern, particularly among young individuals, requiring increased awareness and education on their risks. Educational systems should provide accurate information to prevent false beliefs, while policymakers must legally regulate new drugs. A coordinated approach is crucial for effective prevention, involving education, media, and support from different organizations. Future studies should focus on the impact of education on attitudes towards NPSs.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Justice for Placebo: Placebo Effect in Clinical Trials and Everyday Practice. 安慰剂的正义:临床试验和日常实践中的安慰剂效应。
Medicines (Basel, Switzerland) Pub Date : 2025-02-24 DOI: 10.3390/medicines12010005
Nebojsa Nick Knezevic, Aleksandar Sic, Samantha Worobey, Emilija Knezevic
{"title":"Justice for Placebo: Placebo Effect in Clinical Trials and Everyday Practice.","authors":"Nebojsa Nick Knezevic, Aleksandar Sic, Samantha Worobey, Emilija Knezevic","doi":"10.3390/medicines12010005","DOIUrl":"10.3390/medicines12010005","url":null,"abstract":"<p><p>The placebo effect has been widely documented across various medical conditions, demonstrating its ability to influence both subjective and objective outcomes. Placebo responses can significantly improve symptoms in these different conditions, such as pain, Parkinson's disease, depression, anxiety, and addiction. Psychological mechanisms, particularly the power of patient expectations, appear to play a central role, with neurobiological evidence supporting the activation of dopamine, endogenous opioids, and endocannabinoids in response to placebo interventions. Studies have demonstrated that placebo injections and more complex procedures, including sham surgeries, can produce therapeutic effects comparable to real treatments, particularly in pain management and neurological disorders. Moreover, placebo responses could be amplified when patients are aware of receiving treatment, as shown by research on open-label placebos and open versus hidden medical treatments. The effectiveness of 0.9% sodium chloride solution as a placebo in clinical trials is debated, with some studies indicating its potential to induce clinical improvements, though it may not be an ideal control in inflammatory pain conditions. Advances in neuroimaging have revealed that placebo treatments trigger tangible biological processes in the brain and body and are supported by psychological and physiological mechanisms that interact, suggesting real biological processes are involved in the observed effects. Overall, the growing understanding of placebo mechanisms suggests that incorporating placebo-based strategies, with patient awareness and appropriate ethical considerations, may offer significant potential for improving patient outcomes, particularly in chronic pain, mental health, and neurological conditions.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond the Needle: Innovative Microneedle-Based Transdermal Vaccination. 超越针头:创新的微针透皮疫苗。
Medicines (Basel, Switzerland) Pub Date : 2025-02-07 DOI: 10.3390/medicines12010004
Hiep X Nguyen
{"title":"Beyond the Needle: Innovative Microneedle-Based Transdermal Vaccination.","authors":"Hiep X Nguyen","doi":"10.3390/medicines12010004","DOIUrl":"10.3390/medicines12010004","url":null,"abstract":"<p><p>Vaccination represents a critical preventive strategy in the current global healthcare system, serving as an indispensable intervention against diverse pathogenic threats. Although conventional immunization relies predominantly on hypodermic needle-based administration, this method carries substantial limitations, including needle-associated fear, bloodborne pathogen transmission risks, occupational injuries among healthcare workers, waste management issues, and dependence on trained medical personnel. Microneedle technology has emerged as an innovative vaccine delivery system, offering convenient, effective, and minimally invasive administration. These microscale needle devices facilitate targeted antigen delivery to epidermal and dermal tissues, where abundant populations of antigen-presenting cells, specifically Langerhans and dermal dendritic cells, provide robust immunological responses. Multiple research groups have extensively investigated microneedle-based vaccination strategies. This transdermal delivery technique offers several advantages, notably circumventing cold-chain requirements and enabling self-administration. Numerous preclinical investigations and clinical trials have demonstrated the safety profile, immunogenicity, and patient acceptance of microneedle-mediated vaccine delivery across diverse immunization applications. This comprehensive review examines the fundamental aspects of microneedle-based immunization, including vaccination principles, transcutaneous immunization strategies, and microneedle-based transdermal delivery-including classifications, advantages, and barriers. Furthermore, this review addresses critical technical considerations, such as treatment efficacy, application methodologies, wear duration, dimensional optimization, manufacturing processes, regulatory frameworks, and sustainability considerations, followed by an analysis of the future perspective of this technology.</p>","PeriodicalId":74162,"journal":{"name":"Medicines (Basel, Switzerland)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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