Disease-related Conditions Research Articles

ROLE OF UPASHAYA IN THE MANAGEMENT OF VIPADIKA KUSHTHA – A CASE REPORT

Upashaya refers to an "Aushadhadijanitasukhanubandhaupashaya" that brings in the comfort, relaxation, and relief of symptoms through Aushadha, Ahara and Vihara. It can be considered a symptomatic treatment, actual treatment, and diagnostic tool. In today's context, utilising Upashaya is crucial for guiding the appropriate treat-ment plan, especially in specific disease-related conditions. Upashaya is classified into two main types: Viparee-ta and Vipareetaarthakari. Among these, Vipareeta Upashaya is the most commonly referenced and practiced; Ubhaya Vipareeta Aushadha is one among the Vipareeta Upashaya, which means Medicines that act as both the cause of the disease and the disease itself. To highlight its role in Upashaya, it is necessary to analyse this con-cept with the intention of practically validating it, for which Vipadika kushta has been taken up for the study. Vipadika kushta is one of the Kshudra Kushta. It is Vata Kaphaja Vyadhi, which is characterised by Sphu-tana(Fissure)either in Pani (palm) or Pada(soles) or both with Teevra Vedana (severe pain). Based on the sources, the incidence rate is 3–4%, but it is one of the major cosmetic issues as well as a hurdle for carrying out routine work. This is the case report of the successful management of Vipadika Kushtha with a single formula-tion, Tila kusumadi Lepa—a 35-year-old male patient who presented with a complaint of Cracks on both feet with severe pain. The patient was given Ayurveda treatment for 15 days. After follow-up, significant improve-ment was observed in signs and symptoms. The present case highlights the potential of a single formulation in managing Vipadika Kushtha.

Systemic Diseases in Patients with Congenital Aniridia: A Report from the Homburg Registry for Congenital Aniridia.

Congenital aniridia is increasingly recognized as part of a complex syndrome with numerous ocular developmental anomalies and non-ocular systemic manifestations. This requires comprehensive care and treatment of affected patients. Our purpose was to analyze systemic diseases in patients with congenital aniridia within the Homburg Aniridia Registry. Our retrospective, monocentric study included patients who underwent a comprehensive ophthalmic examination at Saarland University Medical Center beginning in June 2003. Age, gender, genetic test results, and information on systemic anomalies were recorded. In addition, parents and affected patients were interviewed about developmental and other disease-related conditions. Data from 337 patients (mean age 22 ± 20 [0.3-90] years; 181 women [53.7%]) were analyzed. Genetic testing was performed in 187 (55.5%) patients. A PAX6 mutation was detected in 174 of 187 (93%) cases, of which 20 (10.7%) had WAGR(O) syndrome. Systemic diseases were detected in 155 of 337 (46%) patients, with the most common being obesity (29 [8.6%]), thyroid disease (28 [8.3%]), hypertension (26 [7.7%]), intellectual disability (22 [6.5%]), diabetes mellitus (19 [5.6%]), auditory perception disorder/speech development delay (16 [4.7%]), and epilepsy (12 [3.6%]). A comprehensive analysis of patients with aniridia and systemic effects reveals the complexity of this rare disorder, which goes beyond ocular symptoms and can have profound effects on metabolic balance, cardiovascular health, and the central nervous system. Therefore, early genetic diagnosis, early systemic checkup, and adequate treatment, as well as cooperation with pediatrists, neurologists, and audiologists, is suggested in congenital aniridia, which should be considered a syndrome and not an isolated ocular disease.

Pharmaceutical Humanities and Narrative Pharmacy: An Emerging New Concept in Pharmacy.

The complexity of our life experiences and the rapid progress in science and technology clearly necessitate reflections from the humanities. The ever-growing intersection between science and society fosters the emergence of novel interdisciplinary fields of research. During the past decade, Medical Humanities arose to meet the need to unravel hidden information beyond technology-driven and fact-based medicine. In the present paper, we put forward the hypothesis that there is a similar requirement to develop Pharmaceutical Humanities as an academic discipline within pharmacy and pharmaceutical biology. Based on Thomas Kuhn's epistemological theory on the structure of scientific revolutions, one may argue that a paradigm change for Pharmaceutical Humanities might open new levels of insight. Many complex diseases (e.g., cancer, neurological diseases, and mental disorders) remain uncurable for many patients by current pharmacotherapies, and the old beaten paths in our therapeutic thinking may at least partly have to be left behind. By taking examples from Pharmaceutical Biology, we attempt to illustrate that the transdisciplinary dialogue with the humanities is fertile ground not only for enlarging our understanding of disease-related conditions but also for exploring new ways of combatting diseases. In this context, we discuss aspects related to traditional herbal medicine, fair access and benefit sharing of indigenous knowledge about medicinal plants, post-traumatic stress syndrome, the opioid crisis, stress myocardiopathy (broken heart syndrome), and global environmental pollution with microplastics. We also explore possibilities for a narrative turn in pharmacy. The urgent need for inter- and transdisciplinary solutions to pressing health-related problems in our society may create a scholarly atmosphere for the establishment of Pharmaceutical Humanities as a fruitful terrain to respond to the current demands of both science and society.

Behavioral assessment to evaluate the analgesic and anti-inflammatory effects of Fagonia bruguieri var. laxa boiss by targeting pro-inflammatory cytokines and prostaglandin pathways.

Fagonia bruguieri var. laxa Boiss., also known as Dhamansa or Dhamaran, is a well-known xerophyte traditionally used for managing pain, inflammation, fever, and related disease conditions. This study was designed to assess the chemical profile of hydromethanolic (70%) extract of F. bruguieri (HMEFB), its analgesic, anti-inflammatory, and antipyretic properties, and the possible mechanisms involved, using rats and mice as experimental animals. HMEFB was subjected to chemical profiling using polyphenolic quantification and HPLC analysis. An oral toxicity test in mice assessed the extract for safety and toxicity. The central analgesic effect of HMEFB was evaluated in rats subjected to hot plate and tail immersion tests. Formalin and capsaicin tests were carried out to further support the evidence of analgesic action. The test of acetic acid-induced writhing was performed in mice to estimate the peripheral analgesic potential. The anti-inflammatory effect was studied by the carrageenan-induced paw edema model, while, an antipyretic study was conducted following the yeast-induced pyrexia method. Moreover, inflammatory cytokines and prostaglandins were estimated in the blood samples of animals from various groups to assess the possible mechanism involved in the anti-inflammatory potential of the extract. The chemical profiling of HMEFB revealed the presence of functionally important polyphenols. The oral toxicity test revealed the safety up to the dose of 5mg/kg b.w. The extract was found to have significant analgesic activity at the doses of 300 and 500mg/kg in hot plate, tail immersion, capsaicin, and formalin tests. Furthermore, HMEFB significantly reversed the acetic acid-induced writhing compared to the control group. Similarly, HMEFB showed a dose-dependent effect against carrageenan-induced paw edema. While, in the yeast-induced pyrexia model, HMEFB showed a decrease in rectal temperature at 300 and 500mg/kg. The extract significantly modulated the levels of pro-inflammatory cytokines and prostaglandins in different treated groups. The results reinforce the folkloric use of F. bruguieri in pain and inflammation by verifying its analgesic and anti-inflammatory activities both via central and peripheral anti-nociceptive mechanisms which authenticate the use of this plant species as a suitable alternative for the alleviation of pain and inflammatory disorders.

Aligning the World Health Organization's (WHO) package of interventions for rehabilitation for cancer with the mission of the International Psycho-Oncology Society's: promoting psychosocial care for all people affected by cancer

Abstract The number of people living with and beyond cancer continues to increase worldwide, bringing significant attention to their rehabilitation needs. Globally, psychosocial services are largely inadequate, with many cancer survivors experiencing unmet psychosocial needs. The World Health Organization (WHO) recognizes rehabilitation as an essential component of universal health coverage to prevent disease-related conditions, while also improving physical and mental functioning and overall well-being. The Package of Interventions for Rehabilitation (PIR) was developed by the WHO to address the global need for rehabilitation across 20 conditions with high prevalence and high levels of associated disability, including cancer. Many aspects of the WHO PIR align with the mission and focus of the International Psycho-Oncology Society (IPOS). This commentary describes the WHO PIR for Cancer and proposes opportunities to advance cancer rehabilitation research, policy, and practice as they align with recent and ongoing initiatives of IPOS.

(Invited) An in Vitro Model of Mechanical Strain Enhances Cellular Uptake of Single-Walled Carbon Nanotubes

Single-walled carbon nanotubes (SWCNTs) are ideal optical biosensors due to their intrinsic near-infrared (NIR) emission, which is highly sensitive, easily tunable, and indefinitely photostable. Due to such desirable properties coupled with appropriate functionalization strategies, SWCNTs have been used in numerous in vitro, live-cell, and in vivo applications. Depending on the type of functionalization as well as cell type, SWCNTs can be internalized by live cells via demonstrated energy-dependent endocytosis processes where they are retained within the endosomal pathway or are expelled by the cells. While this uptake and intracellular processing of SWCNTs has been recently examined, these studies are usually performed with standard cell culture techniques in petri dishes or 3D cultures. Unlike these cultures, cells in living organisms are continuously exposed to a wide variety of stimuli, e.g., periodic mechanical strain, during both normal and disease-related conditions. Thus, it is important to investigate how cells under physiological stretching compare to those grown in standard cultures. Herein, using a novel cell stretching platform to mimic physiological conditions, we investigate the uptake of SWCNTs into different human cancer cells.Our results indicate that cells exposed to uniform radial stretching display significantly higher rates of nanoparticle uptake, which can be correlated to their increased level of cellular activity. This approach recognizes the importance of studying cellular responses in environments that more closely resemble the complex conditions found in living organisms. It suggests a potential connection between mechanical stimuli and cellular processes related to SWCNT uptake. This finding has implications for understanding how nanotube uptake differs in different cellular stress environments and how cells respond to their dynamic and ever-changing microenvironment.Investigating how the mechanical strain influences the endocytosis processes and subsequent intracellular fate of SWCNTs can provide valuable insights into the interplay between nanomaterials and living cells under more realistic conditions. Further aiding us in the development of more accurate intracellular biosensors and effective drug delivery platforms using SWCNTs.

EPH112 Prevalent Comorbidities and Disease-Related Conditions in Heavily Pre-Treated Patients With Multiple Myeloma: A Real-World Retrospective Database Analysis

EPH112 Prevalent Comorbidities and Disease-Related Conditions in Heavily Pre-Treated Patients With Multiple Myeloma: A Real-World Retrospective Database Analysis

Nasopharyngeal cyst of branchiogenic origin: a rare case report

Nasopharyngeal branchial cysts present laterally as well as ascend from the fossa of Rosenmuller and trace superiorly inside the bony immures of the pharyngotympanic tube. Other commonly related disease conditions with respect to nasopharyngeal cyst include the Rathke’s pouch cyst, Thornwaldt cyst from the pharyngeal bursa along with the branchial cleft cyst. Here in our study, we report a case of a 25-year-old male presented with symptoms of snoring for the past 2 years. On zero-degree endoscopic examination, a nasopharyngeal mass was seen arising from the lateral wall of the nasopharynx extending to the oropharynx. Further based on his radiological investigations, a localized non-enhancing nasopharyngeal cystic mass was seen extending from the left lateral wall of nasopharynx to oropharynx and was diagnosed as nasopharyngeal cyst. Thus, the surgical removal of the nasopharyngeal cyst has been performed through a transoral endoscopic technique with no remnants at the surgical site. The histopathological findings revealed stratified squamous epithelium with subepithelial infiltration of lymphoid follicles, thus confirming the diagnosis as branchial cleft cyst. The patient was discharged with no complications and have been periodically advised for a follow-up. Conclusively, the cyst of 2nd branchiogenic origin in the nasopharynx is extremely sporadic and till date, only a small number of cases have been reported.

Community integration and its predictors in people with stroke: a multicenter longitudinal study.

To investigate the community integration of patients following stroke and determine the predictors of their level of community integration at 1-year follow-up. A multicenter, longitudinal, and observational study. Sixty-five inpatients (41 men) with a mean age of 56.9 (standard deviation = 17.0) years, who had their first stroke at least 1 month prior to this study were recruited from 4 rehabilitation inpatient wards in China. In the initial assessment, the participants were evaluated using the Community Integration Questionnaire, the Fugl-Meyer Assessment, the Berg Balance Scale, the Modified Barthel Index, the Mini Mental State Examination, and the Modified Ashworth Scale. In the follow-up assessments, which were conducted via telephone no less than 1 year after discharge, the participants were evaluated using the Community Integration Questionnaire and also assessed for other disease-related conditions. The participants' scores on the Community Integration Questionnaire in the follow-up assessment were significantly greater than those at the initial assessment (p < 0.05). In addition, the participants' Community Integration Questionnaire scores in the follow-up assessment were significantly correlated with their ages, numbers of years of education, and Modified Barthel Index, Berg Balance Scale, Mini Mental State Examination scores in the initial assessment (p < 0.05), and marginally significantly correlated with their scores on Fugl-Meyer Assessment in the initial assessment (p = 0.058). The participants' ages, numbers of years of education, and Modified Barthel Index, Berg Balance Scale, Mini Mental State Examination, Fugl-Meyer Assessment of the lower extremity, and Fugl-Meyer Assessment scores in the initial assessment were predictive of their Community Integration Questionnaire scores at follow-up, with coefficients of determination ranging from 0.254 to 0.056 (p < 0.05). The level of community integration of the participants was generally low, but it was greater at 1-year follow-up than it was initially. Balance function and daily living ability may be key predictors of community integration of patients following stroke.

ICGA-GPT: report generation and question answering for indocyanine green angiography images

BackgroundIndocyanine green angiography (ICGA) is vital for diagnosing chorioretinal diseases, but its interpretation and patient communication require extensive expertise and time-consuming efforts. We aim to develop a bilingual ICGA report...

Association between patient adherence and treat-to-target in gout: A cross-sectional study.

The implementation of a treat-to-target (T2T) approach has been widely recommended for achieving optimal outcomes in gout treatment, as substantiated by a wealth of compelling evidence. However, a paucity of knowledge exists regarding the barriers hindering effective T2T management in China. This study seeks to investigate the factors contributing to treatment failure within the context of the T2T strategy. A cross-sectional, multi-center investigation was conducted, involving the completion of electronic questionnaires by outpatients undergoing urate-lowering treatment for a duration exceeding 6 months. These questionnaires encompassed demographic information, disease-related conditions, comorbid conditions, and management. The study analyzed factors associated with serum uric acid levels exceeding 360 µmol/L, poor disease control, and poor medication adherence. A total of 425 valid questionnaires were collected, representing 90.8% of the patients. The T2T implementation rate was 26.82% (n = 114). Factors linked to serum uric acid levels surpassing 360 µmol/L included moderate medication adherence (odds ratio (OR) = 2.35; 95% confidence interval (CI) 1.17-4.77; P = .016), poor medication adherence (OR = 4.63; 95% CI 2.28-9.51; P < .001), and management by general practitioners (OR = 0.60; 95% CI 0.37-0.97; P = .036). The rate of well-controlled patients was 14.35% (n = 61). Predictors of not well controlled encompassed the presence of tophi (OR = 2.48; 95% CI 1.17-5.61; P = .023), general medication adherence (OR = 2.78; 95% CI 1.28-6.05; P = .009), poor medication adherence (OR = 6.23; 95% CI 2.68-14.77; P < .001), and poor patient's perception of gout (OR = 4.07; 95% CI 1.41-13.91; P = .015). A poor medication adherence rate of 55.29% (n = 235) was observed, with lower rates of poor medication adherence associated with the use of febuxostat (OR = 0.35; 95% CI 0.14-0.83; P = .02), uric acid levels exceeding 360 µmol/L (OR = 3.05; 95% CI 1.84-5.12; P = .00), moderate patient education (OR = 2.28; 95% CI 1.29-4.15; P = .01), moderate diet control (OR = 1.98; 95% CI 1.17-3.41; P = .01), and poor diet control (OR = 3.73; 95% CI 1.26-12.83; P = .02). The rate of T2T implementation in China is notably low among patients undergoing urate-lowering treatment of gout beyond 6 months. Importantly, medication adherence demonstrates a significant association with T2T outcomes.

Management of cardiovascular disease in patients with schizophrenia

Background: Individuals with schizophrenia experience premature mortality by approximately 15 to 20 years compared to the general population. The most common cause of death in schizophrenia is cardiovascular disorder, yet cardiovascular disease-related conditions are often neglected in the treatment of schizophrenia.Current Concepts: The overall incidence rate of cardiovascular disorders in patients with schizophrenia is about 10%. Diverse risk factors likely contribute to the association, with increased risk of metabolic syndrome, unhealthy lifestyle behaviors like smoking and a sedentary lifestyle, and an unhealthy diet playing a prominent role. While the effects of certain psychotropic medications, particularly atypical antipsychotics, may contribute to the presence of metabolic syndrome, their ability to reduce the psychiatric symptom burden reduces mortality. Shared pathophysiological mechanisms, including genetic, psychological, and inflammatory factors, have also been suggested. In particular, increased inflammation directly associated with disease-related brain activity may further impact the cardiovascular risk.Discussion and Conclusion: Regular monitoring of metabolic syndrome, with psychoeducation for patients and their caregivers, is crucial to promote optimal cardiovascular health. Implementation of active psychosocial interventions targeted at behavior change is necessary. In addition, education to reduce stigma among medical professionals is warranted to improve communication between patients and medical professionals.

Death Unpreparedness Due to the COVID-19 Pandemic: A Concept Analysis.

The COVID-19 pandemic imposed changes upon the capacity of healthcare systems, with significant repercussions on healthcare provision, particularly at end-of-life. This study aims to analyze the concept map of death unpreparedness due to the COVID-19 pandemic, capturing the relationships among the attributes, antecedents, consequences, and empirical indicators. Walker and Avant's method was used to guide an analysis of this concept. A literature search was performed systematically, between May 2022 and August 2023, using the following electronic databases on the Elton Bryson Stephens Company (EBSCO) host platform: Medical Literature Analysis and Retrieval System Online (Medline), Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, and Nursing and Allied Health Collection. Thirty-four articles were retrieved. The unexpected and unpredictable impositions associated with inexperience and unskillfulness in dealing with COVID-19 configured challenges for healthcare professionals, family/caregivers, and even the dying person. Nine key attributes emerged in three main domains: (1) Individual: (a) disease-related conditions, (b) separation distress, and (c) scarcity of death and grief literacy; (2) Relational: (a) Dying alone, (b) poor communication, and (c) existential issues; and (3) Contextual: (a) disrupted collective mourning and grieving, (b) disrupted compassionate care and, (c) pandemic social stigma. This study contributed a full definition of death unpreparedness in a global pandemic scenario such as COVID-19. In this sense, feeling unprepared or unready for death brought new challenges to the bioecological resources of those affected. It is essential to embrace strategies capable of providing emotional and spiritual support in the dying process and to respect patient wishes. The lessons learned from COVID-19 should be applied to events with a comparable impact to minimize their consequences.

In-silico investigation of RPS6KB1 associated cancer inhibitor: a drug repurposing study

The ribosomal protein S6 kinase beta-1 (RPS6KB1), also known as p70S6 kinase, plays a crucial role in various disease-related conditions such as diabetes, obesity, and cancer. Its activity is regulated by phosphorylation events, including phosphorylation of Threonine 389 in the hydrophobic motif by the mammalian target of rapamycin complex 1 (mTORC1) and phosphorylation of Threonine 229 in the activation loop by PDK1 (phosphoinositide-dependent kinase 1). However, other phenomena connected to RPS6KB1 remain unknown. In this study, we employed virtual screening and molecular docking techniques on the molecules in the ZINC library to identify potential inhibitors. Molecular dynamics (MD) simulations and MMGBSA calculations were carried out on promising compounds to determine their binding affinity and stability. We also evaluated the drug-likeness properties of the selected compounds. A comparative study between the native RPS6KB1 structure, co-crystal ligands, and the shortlisted molecules from the ZINC dataset was carried out. The identified molecules possess significant potential for future in vitro and in vivo studies, paving the way for developing effective cancer treatments. Communicated by Ramaswamy H. Sarma

Increasing the Value of Real-World Crowdsourcing Health Data with e-MetaBio, a Novel Patient-Centric IT Infrastructure

ABSTRACT Introduction Digital health and evolutionary medicine create new insights of mediation and health treatment plan support, introducing crowdsourcing and patients’ real-world data records, so as to promote the development of high-quality healthcare accessible to everyone. Within the scope of its activities Metabio’s team has developed an interoperable unified method and technology for crowd-generated databases, creating a user-friendly platform for data collection, processing, and distribution among stakeholders within the global healthcare system in real time. Methods In this paper we describe standard methodologies, requirements, issues, and challenges for the design and deployment of an advanced IT infrastructure for longitudinal structured patient-related data records, based on a patient-centric model of operation, as well as the difficulties for the development of disease-specific user-prefixed interface for real-world data collection. Results Through a dynamic real-time (DRT) e-consent module and digital rights management protocols, the overall platform enables patients to monitor and manage their disease-related conditions, as well as for healthcare providers and/or research entities to have access to valuable biomedical patient data, not recorded so far. Conclusion The project introduces novel perspectives for future evidence-based practices, promoting research and development and improving current healthcare systems, by using crowd-generated data sources that bring a much higher degree of accuracy and value for the entire healthcare system.

Immune System, Inflammation and Autoantigens in Wet Age-Related Macular Degeneration: Pathological Significance and Therapeutic Importance.

Wet age-related macular degeneration (wAMD) is a chronic inflammation-associated neurodegenerative disease affecting the posterior part of the eye in the aging population. Aging results in the reduced functionality of cells and tissues, including the cells of the retina. Initiators of a chronic inflammatory and pathologic state in wAMD may be a result of the accumulation of inevitable metabolic injuries associated with the maintenance of tissue homeostasis from a young age to over 50. Apart from this, risk factors like smoking, genetic predisposition, and failure to repair the injuries that occur, alongside attempts to rescue the hypoxic outer retina may also contribute to the pathogenesis. Aging of the immune system (immunosenescence) and a compromised outer blood retinal barrier (BRB) result in the exposure of the privileged milieu of the retina to the systemic immune system, further increasing the severity of the disease. When immune-privileged sites like the retina are under pathological stress, certain age- and disease-related conditions may necessitate assistance from cells distant from the resident ones to help restore the functionality of the tissue. As a necessary part of tissue repair, inflammation is a major response to disease and recruits immune cells to the site of damage. We suspect that the specific reparative inflammatory responses are controlled by an autoantigen-T cell-mediated mechanism, a process that may be hindered in wAMD.

Neuronal and astrocyte NCX isoform/splice variants: How do they participate in Na+ and Ca2+ signalling?

NCX1, NCX2, and NCX3 gene isoforms and their splice variants are characteristically expressed in different regions of the brain. The tissue-specific splice variants of NCX1–3 isoforms show specific expression profiles in neurons and astrocytes, whereas the relevant NCX isoform/splice variants exhibit diverse allosteric modes of Na+- and Ca2+-dependent regulation. In general, overexpression of NCX1–3 genes leads to neuroprotective effects, whereas their ablation gains the opposite results. At this end, the partial contributions of NCX isoform/splice variants to neuroprotective effects remain unresolved. The glutamate-dependent Na+ entry generates Na+ transients (in response to neuronal cell activities), whereas the Na+-driven Ca2+ entry (through the reverse NCX mode) raises Ca2+ transients. This special mode of signal coupling translates Na+ transients into the Ca2+ signals while being a part of synaptic neurotransmission. This mechanism is of general interest since disease-related conditions (ischemia, metabolic stress, and stroke among many others) trigger Na+ and Ca2+ overload with deadly outcomes of downstream apoptosis and excitotoxicity. The recently discovered mechanisms of NCX allosteric regulation indicate that some NCX variants might play a critical role in the dynamic coupling of Na+-driven Ca2+ entry. In contrast, the others are less important or even could be dangerous under altered conditions (e.g., metabolic stress). This working hypothesis can be tested by applying advanced experimental approaches and highly focused computational simulations. This may allow the development of structure-based blockers/activators that can selectively modulate predefined NCX variants to lessen the life-threatening outcomes of excitotoxicity, ischemia, apoptosis, metabolic deprivation, brain injury, and stroke.

Antioxidant and Anti-Inflammatory Mechanisms of Cardamonin through Nrf2 Activation and NF-kB Suppression in LPS-Activated BV-2 Microglial Cells.

Chronic oxidative stress (OS) and inflammation are implicated in developing and progressing neurodegenerative diseases (NDs). The chronic activation of microglia cells leads to the overproduction of several substances, including nitric oxide and reactive oxygen species, which can induce neurodegeneration. Natural compounds have recently been investigated for their potential to protect cells from OS and to improve many disease-related conditions. Cardamonin (CD) is a bioactive compound in many plants, such as Alpinia katsumadai and Alpinia conchigera. The present study examined the effects of CD on LPS-activated BV-2 microglial cells. The cell viability results showed that the increasing concentrations of CD, ranging from 0.78 to 200 µM, induced BV-2 cell cytotoxicity in a dose-response manner. In the nitric oxide assay, CD concentrations of 6.25 to 25 µM reduced the release of nitric oxide in LPS-activated BV-2 cells by 90% compared to those treated with LPS only (p ≤ 0.0001). CD (6.25 µM) significantly decreased the cellular production of SOD (3-fold (p ≤ 0.05)) and increased the levels of expression of CAT (2.5-fold (p ≤ 0.05)) and GSH (2-fold (p ≤ 0.05)) in the LPS-activated BV-2 cells. Furthermore, on RT-PCR arrays, CD (6.25 µM) downregulated mRNA expression of CCL5/RANTES (5-fold), NOS2 (2-fold), SLC38A1 (3-fold), TXNIP (2-fold), SOD1 (2-fold), SOD2 (1.5-fold) and upregulated GSS (1.9-fold), GCLC (1.7-fold) and catalase (2.9-fold) expression, indicating CD efficacy in modulating genes involved in OS and inflammation. Furthermore, CD (6.25 µM) increased the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and lowered the levels of Kelch-like ECH-associated protein 1 (Keap1), indicating that this may be the signaling responsible for the elevation of antioxidant factors. Lastly, the results showed that CD (6.25 µM) modulated genes and proteins associated with the NF-kB signaling, downregulating genes related to excessive neuroinflammation. These results imply that CD may be a potential compound for developing therapeutic and preventive agents in treating neurodegeneration induced by excessive OS and inflammation.

Risk reduction intervention for raised blood pressure (REVERSE): protocol for a mixed-methods feasibility study

IntroductionAround 40% of adults have pre-hypertension (blood pressure between 120–139/80–89), meaning they are at increased risk of developing hypertension and other cardiovascular disease-related conditions. There are limited studies on the...

Representation of Racial and Ethnic Minorities in Nephrology Clinical Trials: A Systematic Review and Meta-Analysis.

Racial and ethnic disparities in clinical trial enrollment are well described. However, whether these disparities are present in nephrology randomized clinical trials has not been previously reported. We performed a systematic review and meta-analysis of 380 randomized clinical trials involving different aspects of kidney disease published between 2000 and 2021. Our results indicate that worldwide reporting of race and ethnicity is poor and that White individuals account for most of the randomized participants with decreased enrollment of Black participants in more recent trials. However, trials conducted in the United States have representation of Black and Hispanic participants consistent with the population prevalence of disease and under-representation of Asian participants. Under-representation of racial and ethnic minorities in clinical trials could worsen disparities, but reporting and enrollment practices in nephrology randomized clinical trials have not been described. PubMed was searched to capture randomized clinical trials for five kidney disease-related conditions published between 2000 and 2021 in ten high-impact journals. We excluded trials with <50 participants and pilot trials. Outcomes of interest were the proportion of trials reporting race and ethnicity and the proportions of enrolled participants in each race and ethnicity category. Among 380 trials worldwide, race was reported in just over half and ethnicity in 12%. Most enrolled participants were White, and Black individuals accounted for ≤10% of participants except in dialysis trials where they accounted for 26% of participants. However, Black participants were enrolled at high proportions relative to disease and population prevalence in US CKD, dialysis, and transplant trials representing 19% of participants in AKI, 26% in CKD, 44% in GN, 40% in dialysis, and 26% in transplant trials. Enrollment of Asian participants was low worldwide except in GN trials with marked under-representation in US CKD, dialysis, and transplant trials. Hispanic individuals represented only 13% of participants in US dialysis trials compared with 29% of US dialysis population. More complete reporting of race and ethnicity in nephrology trials is needed. Black and Hispanic patients are well-represented in kidney disease trials in the United States. Asian patients are poorly represented in kidney trials both globally and in the United States.