American journal of therapeutics最新文献

{"title":"Safety and Efficacy of Semaglutide in Patients With Chronic Kidney Disease and Type 2 Diabetes Mellitus, With or Without Cardiovascular Disease: A Systematic Review and Meta-Analysis of 10,013 Patients.","authors":"Adarsh Raja, Asfia Qammar, Sumet Kumar, Hafsah Alim Ur Rahman, Sandesh Raja, Mukesh Kumar","doi":"10.1097/MJT.0000000000001828","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001828","url":null,"abstract":"","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e303-e306"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Analysis of Therapeutic Efficacy and Prognosis of Neoadjuvant Chemotherapy in Patients With Mid to Low Locally Advanced Rectal Cancer.","authors":"Qinping Guo, Kang Wang, Chao Yu, Li Yao, Zhenguo Han","doi":"10.1097/MJT.0000000000001812","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001812","url":null,"abstract":"","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e294-e297"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Guidelines for Direct-To-Consumer Promotion of Transcranial Magnetic Stimulation.","authors":"Dan Alexandru Constantin, Ionut Horia Cioriceanu, Liliana Marcela Rogozea","doi":"10.1097/MJT.0000000000001974","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001974","url":null,"abstract":"<p><strong>Background: </strong>Medical providers started to consider Transcranial Magnetic Stimulation (TMS) for the noninvasive treatment of different psychiatric and neurology disorders as this technique become more popular in recent years. Many medical providers are trying to reach patients using direct-to-consumer (DTC) promotion of approved and off-label indications. Most of the time, these ads exaggerate benefits, create unrealistic expectations, and often exaggerate benefits. The procedure is expensive, and many insurance companies do not reimburse it; some patients may not have access to it. The study examines the ethical issues related to DTC promotion of TMS. It proposes clear ethical guidelines for transparency, equity, informed consent, data privacy, and regulation. These measures aim to encourage responsible marketing practices while ensuring the welfare of patients is protected.</p><p><strong>Areas of uncertainty: </strong>The best practice guide does not include patient autonomy and transparency in DTC advertising for TMS. Examining specialist publications, regulations, and ethical considerations ensures the structuring of ethical guidelines and the responsible promotion of DTC's medical marketing.</p><p><strong>Data sources: </strong>A comprehensive literature review was conducted in the PubMed, PsycINFO, BMC, and Google Scholar databases from their inception to 2025 using keywords related to TMS, regulatory compliance, DTC, marketing ethics, and patient impact. Studies that contained information regarding misinformation risks, patients' decision making, ethical guidelines in medical advertising, and DTC promotion were analyzed.</p><p><strong>Results: </strong>The analysis of these studies identified key ethical concerns that include insufficient regulatory oversight, misleading claims that exaggerate benefits and downplay risks, privacy risks in targeted advertising, lack of standardized informed consent procedures, and limited access due to high treatment costs. Our study proposes ethical guidelines based on the ethical concerns identified that medical providers can use to ensure that patients have equitable access, transparency, and regulatory accountability.</p><p><strong>Conclusions: </strong>Implementing our guidelines will ensure that patients receive unbiased information, high-quality care, and equitable access, reinforcing TMS's ethical foundation in clinical practice.</p>","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e269-e273"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Memantine-Associated Decrease in Renal Function and Hyperuricemia.","authors":"Tsukasa Murata, Yusuke Yamaguchi, Yuki Kurauchi, Takahiko Nagamine","doi":"10.1097/MJT.0000000000001807","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001807","url":null,"abstract":"","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e291-e294"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Knowledge and Implementation of Therapeutic Strategies in Cardio-Oncology: A National Physician-Based Survey.","authors":"Andreea Cristina Ivanescu, Cornelia Nitipir, Horia Bumbea, Elisabeta Badila, Gheorghe-Andrei Dan","doi":"10.1097/MJT.0000000000001970","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001970","url":null,"abstract":"<p><strong>Background: </strong>Cardio-oncology has developed as an intersection science and practice, balancing the risks and benefits of chemotherapy treatment. Implementing a cardio-oncology program in practice is currently one of the most challenging areas of clinical medicine. In Romania, there are scarce cardio-oncology centers and no dedicated training programs. Thus, the care of these patients is highly heterogeneous and empirical, often without following guideline recommendations.</p><p><strong>Study question: </strong>This study evaluates the awareness and knowledge of cardio-oncology diagnosis and treatment strategies among Romanian physicians.</p><p><strong>Study design: </strong>A cross-sectional validated online survey was sent to clinicians treating oncological patients with cardiovascular (CV) risk or associated CV pathology.</p><p><strong>Measures and outcome: </strong>The survey covered formal training, knowledge of basic cardio-oncology concepts, and therapy.</p><p><strong>Results: </strong>One hundred ninety professionals responded to our questionnaire, most being cardiologists (73.2%), 20.5% oncologists/hematologists, and the remaining had other specialties. Only 21 respondents mentioned the availability of dedicated cardio-oncology teams. Eighty percent would not prescribe prophylactic medication before starting a potentially cardiotoxic oncological treatment in patients with a normal left ventricular ejection fraction and low CV risk. Even in patients with high CV risk, 34.7% would still not prescribe medication for primary prevention of cardiotoxicity. However, most respondents (63.2%) did not consider chemotherapy in patients at high risk of CV events. Most respondents (90.5%) recommend direct oral anticoagulants for CV pathology if indicated. For acute coronary syndromes under fluoropyrimidine treatment, the responses are heterogeneous for all specialties, with a tendency to stop chemotherapy for cardiologists. Sixty-four respondents considered long QT secondary to oncologic treatment a reason to interrupt treatment, with cardiologists more likely to consider it.</p><p><strong>Conclusions: </strong>This survey highlights the heterogeneity in understanding, preventing, and treating CV toxicity. It emphasizes the lack of clear, well-implemented clinical practice algorithms in the population studied. Our survey underlines the gap between guidelines and clinical practice.</p>","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e223-e233"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Proton Pump Inhibitors in Prevention of Upper Gastrointestinal Bleeding in Patients on Dual Antiplatelet Therapy: Systematic Review and Meta-Analysis.","authors":"Aamir Saeed, Marjan Haider, Saira Yousuf, Soban Ahmad, Michael Fine, Ali Yazdani, Umar Hayat, Nicholas Noverati, Muhammad Ali Khan, Manesh Kumar Gangwani, Muhammad Aziz, Umer Farooq, Faisal Kamal","doi":"10.1097/MJT.0000000000001834","DOIUrl":"10.1097/MJT.0000000000001834","url":null,"abstract":"<p><strong>Background: </strong>Dual antiplatelet therapy (DAPT) with oral P2Y12 inhibitors and aspirin is crucial for patients with acute coronary syndrome (ACS) and postpercutaneous coronary interventions (PCI). Concomitant proton pump inhibitor (PPI) therapy with DAPT can potentially reduce the risk of upper gastrointestinal bleeding (UGIB).</p><p><strong>Aim: </strong>We conducted a meta-analysis of randomized controlled trials to evaluate the prevention of UGIB with concomitant use of PPI with DAPT.</p><p><strong>Methods: </strong>We reviewed several databases to identify randomized controlled trials comparing the risk of UGIB in patients using DAPT + PPI vs . DAPT with no PPI or DAPT + Histamine 2 receptor antagonists. Our outcomes of interest were UGIB, major cardiovascular adverse events (MACE), myocardial infarction, and all-cause mortality. We calculated pooled risk ratio (RR) with 95% confidence intervals (CI) for all of the outcomes and analyzed data using random effect model. Heterogeneity was assessed using I 2 statistic.</p><p><strong>Results: </strong>Seven randomized controlled trials comprising 6708 patients were included. Rate of UGIB was significantly lower in the PPI + DAPT group, RR (95% CI): 0.39 (0.25-0.60). There was no significant difference in the rate of MACE between groups, RR (95% CI): 0.87 (0.69-1.10). Rate of MI was also not significantly different between groups, RR (95% CI): 0.93 (0.75-1.14). Rate of mortality was significantly lower in the PPI + DAPT group, RR (95% CI) 0.46 (0.27-0.80).</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrates that adding PPI therapy to DAPT significantly lowers the risk of UGIB and all-cause mortality, without adversely affecting major cardiovascular outcomes.</p>","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e256-e261"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Potential of Sodium-Glucose Cotransporter-2 Inhibitors in Nonalcoholic Fatty Liver Disease: A Network Meta-analysis.","authors":"Kannan Sridharan, Gowri Sivaramakrishnan","doi":"10.1097/MJT.0000000000001813","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001813","url":null,"abstract":"","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e297-e301"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abrocitinib in the Treatment of Drug Reaction With Eosinophilia and Systemic Symptoms.","authors":"ZhiQin Zhang, Juan Liu, Di Wu, WeiLing Sun, ZhiQiang Yin","doi":"10.1097/MJT.0000000000001865","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001865","url":null,"abstract":"","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e284-e286"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Use of Ketamine in Treatment-Resistant Depression and Other Psychiatric Disorders: A Scoping Review of Practice Patterns, Efficacy, and Patient Demographic Trends.","authors":"Amna M Aslam, Kenneth Shinozuka, Owen Muir, Burton J Tabaac","doi":"10.1097/MJT.0000000000001951","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001951","url":null,"abstract":"<p><strong>Background: </strong>Ketamine has emerged as a novel treatment for psychiatric disorders, particularly treatment-resistant depression (TRD). Although intravenous (IV) ketamine is not approved by the Food and Drug Administration (FDA) for TRD, esketamine, an FDA-approved therapeutic, has contributed to the widespread clinical use of off-label IV ketamine across the United States. This scoping review highlights significant shifts in ketamine therapy, particularly after FDA approval of esketamine, the impact of COVID-19 on treatment accessibility, and increased regulatory scrutiny from the Drug Enforcement Administration (DEA) and FDA.</p><p><strong>Areas of uncertainty: </strong>What are the current practice patterns, patient demographics, and barriers to accessing ketamine for psychiatric disorders, particularly TRD?</p><p><strong>Data sources: </strong>This scoping review focused on provider utilization patterns (including frequency of ketamine administration, provider roles, and treatment settings), preferred administration methods (IV infusions, intramuscular injections, and other routes), and patient characteristics (age, sex, socioeconomic status, and primary psychiatric diagnoses treated). The Web of Science, PubMed, CBM, MEDLINE, Cochrane Library, University Theses, and Embase databases were searched.</p><p><strong>Results: </strong>Two survey-based studies were included. IV administration was the most common method of administration reported in both studies, with alternative methods such as intramuscular and sublingual routes emerging in limited use. Patients receiving ketamine therapy were predominantly middle aged (36-64 years old), with financial barriers identified as a notable obstacle because of limited insurance coverage. Access to ketamine was limited in rural areas, illustrating the need for expanded provider networks. Private clinics exhibited greater flexibility in treatment approaches than hospital settings, which adhered to standardized protocols. The absence of long-term outcome data and variability in treatment protocols emphasize the need for standardized practices and further research.</p><p><strong>Conclusions: </strong>This scoping review highlights the widespread use of ketamine for TRD, but reveals significant variability in practice patterns and accessibility barriers. Findings emphasize the need for standardized protocols, expanded insurance coverage, and further research to optimize the role of ketamine in psychiatric care.</p>","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e242-e246"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Adrenergic Blockers for Acute Myocardial Infarction: 50 years of Expert Opinions in Cecil Textbook of Medicine.","authors":"Peter Manu, Gheorghe-Andrei Dan","doi":"10.1097/MJT.0000000000001939","DOIUrl":"https://doi.org/10.1097/MJT.0000000000001939","url":null,"abstract":"<p><strong>Background: </strong>The beta-adrenergic blocker propranolol was synthesized in 1964 by James Black working at the Imperial Chemical Industries in England. The drug did not demonstrate encouraging effects regarding mortality of patients with acute myocardial infarction in clinical trials published in the 1960s in Great Britain and soon thereafter in other countries, but seemed promising after very large studies were conducted in the 1980s in the United States and elsewhere.</p><p><strong>Study question: </strong>What are the milestones of the beta-adrenergic blocker use recommended by experts for the pharmacological management of acute myocardial infarction in the United States?</p><p><strong>Study design: </strong>To determine the changes in the experts' approach to the management of acute myocardial infarction regarding the use of beta-adrenergic blockers as presented in a widely used textbook in the United States.</p><p><strong>Data sources: </strong>The chapters describing the management of acute myocardial infarction in the 15 editions of Cecil Textbook of Medicine updated by recognized experts for clinicians from 1967 through 2020.</p><p><strong>Results: </strong>Beta-adrenergic blockers such as propranolol, timolol, and metoprolol were first mentioned in Cecil Textbook of Medicine in 1985 and recommended unreservedly in Cecil Medicine only since 2000. The record suggests that the expert opinions were shaped by large clinical trials published in the United States in the early 1980s.</p><p><strong>Conclusions: </strong>The decades long delay in the change in the experts' opinion regarding the utility of beta-adrenergic blockers in acute myocardial infarction in the United States is an instance of prudence and well-tempered clinical judgment.</p>","PeriodicalId":7760,"journal":{"name":"American journal of therapeutics","volume":"32 3","pages":"e274-e277"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}