Medical Literature Research Articles

Pubertal induction therapy in pediatric patients with Duchenne muscular dystrophy.

We conducted a scoping review and analyzed the medical literature on PubMed to assess any potential short-term and long-term benefits of pubertal induction in patients with DMD. We identified six articles from our research cumulatively reporting clinical data from 58 pediatric patients with DMD, of age between 12 and 17.7 years. All of them were on glucocorticoid therapy with variable duration and the longest follow-up of 11.7 years. In all patients, the induction protocol was successful (leading to appearance of secondary sexual characteristics); no secondary effects were reported by any analyzed studies. Three papers reported an objective improvement of patients' quality of life, while in four there was a benefit on the bone profile. Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic disorder that affects approximately 1 in 5,000 live-born male children. Because of early and chronic exposure to glucocorticoids, used as standards of care, pubertal development may be variable. While some boys experience a normal pubertal growth spurt, others have testosterone levels below the normal range for age and require pubertal induction therapy to achieve an adequate testicular volume, development of secondary sexual characteristics, and peak bone mass. When and how to use pubertal induction therapy in pediatric patients with DMD is still object of controversy. The reported evidence of testosterone therapy in patients with DMD is still limited to small cohort sizes, which suggest efficacy and psychosocial benefits.

Efficacy of nutrient supplements in managing malnutrition and sarcopenia in Chronic Obstructive Pulmonary Disease (COPD) patients: a protocol for systematic review and meta-analysis

BackgroundCOPD patients suffering from malnutrition or sarcopenia often incur higher healthcare costs and experience adverse clinical outcomes. Despite this, the effectiveness of nutrient supplements in this population remains uncertain.Methods and analysisTwo reviewers will independently search seven databases—PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database, and the Cochrane Library—for randomized controlled trials (RCTs) published before August 31, 2024. These RCTs should compare the effects of nutrient supplements against either a standard diet or placebo supplements in patients with COPD. The risk of bias in the included studies will be evaluated using the modified Jadad scale and the Cochrane Collaboration's risk of bias tool. Data synthesis will be conducted using RevMan software. Trial sequential analysis (TSA) will be applied to the primary outcomes. Additionally, subgroup and sensitivity analyses will be performed to assess the robustness of the findings.Ethics and disseminationEthical approval is not required because this study is a secondary analysis of existing data. We will disseminate the findings through peer- reviewed publications.Systematic review registrationCRD42024585694.Strengths and limitations of this studyThis systematic review and meta-analysis provides a thorough assessment of the efficacy of nutrient supplements in COPD patients, covering a wide range of studies.·The use of the modified Jadad scale and the Cochrane Collaboration's risk of bias tool ensures a robust evaluation of study quality. Additionally, trial sequential analysis and subgroup analyses are employed to enhance the robustness of the findings.·The credibility of the evidence may be compromised due to the potential for uncertain study quality and limited sample sizes in some included trials.

Efficacy and safety of Chinese classical prescriptions for dilated cardiomyopathy: a systematic review and Bayesian network meta-analysis

BackgroundChinese classical prescriptions (CCPs) are commonly utilized in China as an adjuvant treatment for dilated cardiomyopathy (DCM). Nevertheless, there was insufficient systematic evidence data to show the advantages of CCPs plus current conventional therapy (CT) against DCM. This network meta-analysis (NMA) sought to evaluate and prioritize the six different CCP types’ respective efficacies for DCM.MethodsA comprehensive search was conducted from the databases’ inception to November 30, 2024, to extract RCTs that addressed the use of CCPs in conjunction with CT for DCM. The databases included PubMed, Embase, Web of Science Core Collection, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science Periodical Database (CSPD), Chinese Citation Database (CCD), Chinese Biomedical Literature Database (CBM), and ClinicalTrials.gov. The Cochrane Risk of Bias assessment tool was used to evaluate the quality of the included RCTs. Surface under the cumulative ranking curve (SUCRA) probability values was employed to rank the relative efficacy. Bayesian network meta-analysis was applied to evaluate the efficacy of various CCPs. This review was registered with PROSPERO (CRD42024586365).ResultsFollowing the application of inclusion and exclusion criteria, 27 eligible RCTs involving 2019 patients were included. The evaluated outcomes included clinical effectiveness rate (CER), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), brain natriuretic peptide (BNP), cardiac output (CO), hypersensitive C-reactive protein (hs-CRP), and six-min walk test (6MWT). According to the NMA, Zhigancao decoction (ZGCD), Zhenwu decoction (ZWD), Shenfu decoction (SFD), Shengmai powder (SMP), Yangxin decoction (YXD), and Buyang Huanwu decoction (BYHW) in addition to CT considerably enhanced DCM treatment outcomes when compared to CT alone. SMP + CT (MD = 12.75, 95%CI 8.28–17.22) showed the highest probability of being the best treatment on account of the enhancement of LVEF. SFD + CT was most likely to be the optimal intervention for LVEDD decrease (MD = -4.68, 95%CI -8.73 to -0.62). YXD + CT (MD = -4.47, 95%CI -4.47 to -4.47) had the highest likelihood of being the optimal therapy for reducing LVESD. ZGCD + CT seemed to be the most promising intervention on the improvement in hs-CRP (MD = -2.82, 95%CI -3.60 to -2.04) and 6MWT (MD = 141.00, 95%CI 136.57 to 145.43). However, the optimal CCP for improving BNP and CO could not be identified based on the present studies. No significant adverse events emerged in the included studies.ConclusionThis NMA indicated that adding CCPs to current CT treatment had a favorable effect on DCM. In light of the clinical efficacy and other outcomes, SMP + CT, SFD + CT, YXD + CT, and ZGCD + CT demonstrated a preferred improvement in patients with DCM when combined. Furthermore, additional larger RCTs with longer follow-up periods and standardized outcome reporting are required to give more solid evidence to support our findings due to the small sample size of the current studies and the presence of risk of bias.

How to Write Effective Prompts for Screening Biomedical Literature Using Large Language Models

Large language models (LLMs) have emerged as powerful tools for (semi-)automating the initial screening of abstracts in systematic reviews, offering the potential to significantly reduce the manual burden on research teams. This paper provides a broad overview of prompt engineering principles and highlights how traditional PICO (Population, Intervention, Comparison, Outcome) criteria can be converted into actionable instructions for LLMs. We analyze the trade-offs between “soft” prompts, which maximize recall by accepting articles unless they explicitly fail an inclusion requirement, and “strict” prompts, which demand explicit evidence for every criterion. Using a periodontics case study, we illustrate how prompt design affects recall, precision, and overall screening efficiency and discuss metrics (accuracy, precision, recall, F1 score) to evaluate performance. We also examine common pitfalls, such as overly lengthy prompts or ambiguous instructions, and underscore the continuing need for expert oversight to mitigate hallucinations and biases inherent in LLM outputs. Finally, we explore emerging trends, including multi-stage screening pipelines and fine-tuning, while noting ethical considerations related to data privacy and transparency. By applying systematic prompt engineering and rigorous evaluation, researchers can optimize LLM-based screening processes, allowing for faster and more comprehensive evidence synthesis across biomedical disciplines.

Assessment of the Efficiency of a ChatGPT-Based Tool, MyGenAssist, in an Industry Pharmacovigilance Department for Case Documentation: Cross-Over Study

Background At the end of 2023, Bayer AG launched its own internal large language model (LLM), MyGenAssist, based on ChatGPT technology to overcome data privacy concerns. It may offer the possibility to decrease their harshness and save time spent on repetitive and recurrent tasks that could then be dedicated to activities with higher added value. Although there is a current worldwide reflection on whether artificial intelligence should be integrated into pharmacovigilance, medical literature does not provide enough data concerning LLMs and their daily applications in such a setting. Here, we studied how this tool could improve the case documentation process, which is a duty for authorization holders as per European and French good vigilance practices. Objective The aim of the study is to test whether the use of an LLM could improve the pharmacovigilance documentation process. Methods MyGenAssist was trained to draft templates for case documentation letters meant to be sent to the reporters. Information provided within the template changes depending on the case: such data come from a table sent to the LLM. We then measured the time spent on each case for a period of 4 months (2 months before using the tool and 2 months after its implementation). A multiple linear regression model was created with the time spent on each case as the explained variable, and all parameters that could influence this time were included as explanatory variables (use of MyGenAssist, type of recipient, number of questions, and user). To test if the use of this tool impacts the process, we compared the recipients’ response rates with and without the use of MyGenAssist. Results An average of 23.3% (95% CI 13.8%-32.8%) of time saving was made thanks to MyGenAssist (P<.001; adjusted R2=0.286) on each case, which could represent an average of 10.7 (SD 3.6) working days saved each year. The answer rate was not modified by the use of MyGenAssist (20/48, 42% vs 27/74, 36%; P=.57) whether the recipient was a physician or a patient. No significant difference was found regarding the time spent by the recipient to answer (mean 2.20, SD 3.27 days vs mean 2.65, SD 3.30 days after the last attempt of contact; P=.64). The implementation of MyGenAssist for this activity only required a 2-hour training session for the pharmacovigilance team. Conclusions Our study is the first to show that a ChatGPT-based tool can improve the efficiency of a good practice activity without needing a long training session for the affected workforce. These first encouraging results could be an incentive for the implementation of LLMs in other processes.

SUBSCAPULARIS MUSCLE FUNCTION IN REVERSE SHOULDER ARTHROPLASTY

Reverse shoulder arthroplasty is currently a common operation, despite this, debates continues about various aspects of the biomechanics of reverse endoprosthesis. In particular, there is no consensus in the medical literature about the function of the subscapularis muscle. Several clinical and biomechanical studies have been conducted to analyze its role in joint stability and influence on range of motion. Some results suggest that the subscapularis muscle improves joint stability but may limit joint range of motion.

DeepMVD: A Novel Multiview Dynamic Feature Fusion Model for Accurate Protein Function Prediction.

Proteins, as the fundamental macromolecules of life, play critical roles in various biological processes. Recent advancements in intelligent protein function prediction methods leverage sequences, structures, and biomedical literature data. Among them, function prediction methods for protein sequences remain an enduring and popular research direction. Existing studies have failed to effectively utilize the multilevel attribute features reflected in protein sequences. This limitation hinders the enrichment of protein descriptions needed for high-precision prediction of protein functions. To address this, we propose DeepMVD, a novel deep learning model that enhances prediction accuracy by dynamically fusing multiview features. DeepMVD employs specialized modules to extract unique features from each view and utilizes an adaptive fusion mechanism for optimal integration. Evaluation of the CAFA4 data set shows that DeepMVD significantly outperforms existing state-of-the-art models in terms of BP, MF, and CC terminology, all obtaining the highest Fmax (0.523, 0.712, 0.740). Ablation studies confirm the model's robustness. Source code and data sets are available at http://swanhub.co/scl/DeepMVD.

Systematic Review of Bisphosphonates and Osteonecrosis of the Jaw

Introduction: Bisphosphonates commonly prescribed for bone-related conditions but are associated with a side effect called osteonecrosis of the jaw (ONJ). This systematic review investigates ONJ incidence and bisphosphonate types among patients. Methods: Comprehensive systematic search of medical literatures identified five relevant studies. These studies reported 42 ONJ cases in bisphosphonate-treated patients, providing data on affected jaw regions, medication usage, and primary diagnoses. Results: Mandible was the most frequently affected osteonecrosis (40 cases), followed by maxilla (9 cases) and both mandible and maxilla (3 cases). Pamidronate was the most commonly associated medication (12 cases), followed by combinations of pamidronate and zoledronic acid (15 cases), zoledronic acid alone (10 cases), and other bisphosphonate combinations (1 case). Primary diagnoses were varied, with myeloma being the most common (18 cases), followed by breast cancer (7 cases), prostate cancer (1 case), renal cancer (1 case), and other diagnoses. Conclusion: There is a risk of ONJ in bisphosphonate-treated patients. Pamidronate and zoledronic acid, often used in combination, were the most frequently implicated medications. Patients with myeloma and breast cancer appear particularly susceptible. Monitoring is crucial considering the risks and benefits of bisphosphonate therapy, particularly in high-risk populations. Keywords: Bisphosphonates; ONJ; Pamidronate; Zoledronic acid

An unusual case of multiple primary tumours involving the long bone and oral cavity.

Multiple primary tumours (MPTs) are a rare clinical entity, and the co-occurrence of synchronous and metachronous MPTs in a single patient is even more exceptional. In the context of Erdheim-Chester Disease (ECD), an already uncommon disorder, the presentation of this disease in the oral cavity is notably rare. Furthermore, the simultaneous presence of ECD in the oral cavity and a Giant Cell Tumour (GCT) in a long bone has not been previously reported in medical literature. This case report presents the first documented instance of such a unique clinical scenario. The marked histological disparities between GCT and ECD further underscore the enigmatic nature of this case. The intricate interplay of genetic, environmental, and pathophysiological factors that led to the simultaneous development of two distinct neoplasms in the same patient is yet to be fully elucidated. This case not only challenges our understanding of the etiology of these conditions but also emphasizes the importance of a multidisciplinary approach to the evaluation and management of such complex cases. The confluence of rare entities, the diagnostic complexities they introduce, and the imperative need for tailored treatment strategies exemplify the intricate landscape of oncological care. This case serves as a compelling reminder of the many unknown facets of disease etiology and the significance of collaborative medical efforts in offering the best possible care for patients confronting exceptionally rare clinical presentations.

A Narrative Approach to Assent in Pediatrics

While narrative approaches to clinical care of adults are lauded in medical literature and training, scant attention is directed to narrative’s potential in the realm of pediatric clinical care. The narrative structure inherent to a narrative medicine framework is particularly well-suited to contextualize clinical care for children while also fostering a child’s decision-making capacity. This article proposes a narrative model of pediatric assent that adapts three steps familiar in narrative models: Narrative Emplotment, Stimulation of Imagination, and Invitation of Assent while Preparing for Dissent. Narrative Emplotment refers to the contextualization of clinical care through the construction of a narrative in partnership with a pediatric patient. Stimulation of Imagination refers to the exploration of potential future options with a child through the use of narrative-directed questions. Finally, Invitation of Assent while Preparing for Dissent refers to pre-emptive steps taken to re-contextualize care following dissent from a child.

The Mortality of Behcet's Disease.

As medical directors, we often receive referrals for an underwriting opinion on rare and unusual diseases. This necessitates time-consuming medical literature searches and analyzing studies for appropriate mortality data. Behcet's disease (BD) belongs in this category. Although this review article does not have all the elements of a typical mortality abstract, with a rare disease such as BD, we must rely on the available literature.

Out-of-hospital assessment and triage of paracetamol (acetaminophen) exposure in the United States and Canada: a consensus guideline.

Consensus guidelines for out-of-hospital assessment and triage of paracetamol (acetaminophen) exposure were published in 2006. Changes in the healthcare system, paracetamol ingestion trends, and availability of paracetamol-containing products necessitate an update to these guidelines. Updated guidelines were created for out-of-hospital management of paracetamol exposure in the United States and Canada. A modified Delphi consensus methodology was used to create a decision framework to evaluate clinical aspects of care related to paracetamol overdose in the out-of-hospital setting. Twenty-one panelists were selected by four clinical toxicology societies (America's Poison Centers®, American Academy of Clinical Toxicology, American College of Medical Toxicology, and Canadian Association for Poison Centres and Clinical Toxicology) to participate as panelists. Guidelines were collected from most poison centers in the United States and Canada, and systematic collection and review of medical literature was conducted. The panel developed a guideline for out-of-hospital management of paracetamol exposure that encompasses acute and repeated supratherapeutic ingestion patterns. Acute ingestion is defined as any ingestion presenting within 24 h of initial ingestion, regardless of ingestion pattern. Repeated supratherapeutic ingestion is defined as an exposure that occurs over a period of 24 h or more. This guideline emphasizes the importance of obtaining accurate history. When ingestion history is determined as accurate, dosage and ingestion pattern are used to decide treatment referral. It is recommended that patients be referred to the emergency department if their ingestion amount is: (1) ≥200 mg/kg or 10 g (whichever is less) within 24 h; (2) ≥150 mg/kg/24 h or 6 g/day (whichever is less) within 48 h; (3) ≥100 mg/kg/24 h or 4 g/day (whichever is less) for more than 48 h. The need for standardizing the out-of-hospital assessment and triage of paracetamol exposure is pressing. Despite the availability of acetylcysteine, some patients develop fatal liver failure due to missed diagnoses and delays in treatment. Failure to recognize cases requiring acetylcysteine is associated with significant morbidity and mortality. This consensus statement provides evidence-based guidance for out-of-hospital management of paracetamol ingestion to standardize healthcare facility referral criteria for paracetamol exposed patients.

Transforming hematological research documentation with large language models: an approach to scientific writing and data analysis.

Large Language Models (LLMs), such as ChatGPT (OpenAI, CA, US), have revolutionized scientific writing and research processes across academic disciplines, providing comprehensive support throughout the entire research lifecycle. Generative artificial intelligence (GAI) tools enhance every aspect of scientific writing, from hypothesis generation and methodology design to data analysis and manuscript preparation. This review examines the applications of LLMs in hematological research, with particular emphasis on advanced techniques, including prompt engineering and retrieval augmented generation (RAG) frameworks. Prompt engineering methods, including zero-shot and few-shot learning along with a chain-of-thought approach, enable researchers to generate more precise context-specific content, especially in scientific writing. Integrating RAG frameworks with the current medical literature and clinical guidelines significantly reduces the risk of misinformation while ensuring alignment with contemporary medical standards. Even though these GAI tools offer remarkable potential for streamlining research writing and enhancing documentation quality, the study also addresses the critical importance of maintaining scientific integrity, ethical considerations, and privacy concerns in hematological research.

Medical foundation large language models for comprehensive text analysis and beyond

Recent advancements in large language models (LLMs) show significant potential in medical applications but are hindered by limited specialized medical knowledge. We present Me-LLaMA, a family of open-source medical LLMs integrating extensive domain-specific knowledge with robust instruction-following capabilities. Me-LLaMA is developed through continual pretraining and instruction tuning of LLaMA2 models using diverse biomedical and clinical data sources (e.g., biomedical literature and clinical notes). We evaluated Me-LLaMA on six text analysis tasks using 12 benchmarks (e.g., PubMedQA and MIMIC-CXR) and assessed its clinical utility in complex case diagnosis through automatic and human evaluations. Me-LLaMA outperforms existing open medical LLMs in zero-shot and supervised settings and surpasses ChatGPT and GPT-4 after task-specific instruction tuning for most text analysis tasks. Its performance is also comparable to ChatGPT and GPT-4 for diagnosing complex clinical cases. Our findings highlight the importance of combining domain-specific continual pretraining with instruction tuning to enhance performance in medical LLMs.

Management of children and adolescents with chronic myeloid leukemia in chronic phase: International pediatric chronic myeloid leukemia expert panel recommendations.

The treatment strategy for children and adolescents with chronic myeloid leukemia in the chronic phase (CML-CP) has evolved from allogeneic hematopoietic stem cell transplantation (HSCT) to tyrosine kinase inhibitors (TKIs). With the advent of next-generation TKIs and new targeted therapies in the CML field, an international pediatric CML expert panel provides recommendations based on the medical literature (including previous pediatric guidelines), national standards, and treatment principles used in adults with CML-CP. Recommendations include diagnosis of the disease and details on managing the initial steps of care of children and adolescents with newly diagnosed CML-CP, including complications such as leukostasis. The treatment recommendations are based on the initiation of therapy with a first- or second-generation TKI according to the allocated European Treatment and Outcome Study (EUTOS) long-term survival score risk group of the patient. The subsequent steps are based on the results of recommended monitoring which can justify a switch to another TKI or a drug in development if there is resistance or toxicity. The panel also provides recommendations regarding the discontinuation criteria for TKIs in children and adolescents in sustained deep molecular response. Allogeneic HSCT is not recommended as the first-line of treatment for children with CML-CP but is to be considered in case of progression to the advanced phase or failure of several lines of treatment. The present treatment and management recommendations are intended to provide advice to clinicians in view of optimizing the care and the outcome of children and adolescents with CML-CP.

Web references are not eternal: time-trend and qualitative impact of the loss of access to online resources cited in peer-reviewed medical journals.

Web resources can contain high-quality data relevant to peer-reviewed medical publications. However, their online location may change or disappear with time. As medical publication professionals, we are concerned with the ephemeral nature of web resources and the associated qualitative impact on publication integrity of referencing such resources. Time-dependence of the phenomenon was probed using a dataset of reference lists from open and free access articles published in 2018. Each reference list was manually screened to tally the number of web pages no longer accessible. The analysis was repeated yearly from 2021 to 2023. Additionally, a set of proofs was analyzed to investigate the proportion of cited web references already inaccessible at publication. A third dataset, consisting of modeling articles published in 2018-2023, was used to quantify -at a single timepoint- the share of web resources cited as model inputs that were inaccessible. The proportion of inaccessible web resources increased on average from 27.2% to 41.9% three to five years post publication (n = 992 articles), respectively. One out of four analyzed proofs cited at least one inaccessible web resource (n = 50). Five years after publication, 26.1% of web resources used as model inputs were no longer accessible, with one in three modeling articles being impacted (n = 61). The issue of inaccessible web resources cited in peer-reviewed medical publications is of great concern due to the fast pace and potential impact on research reproducibility. These findings call for the definition of best practices involving all stakeholders and the deployment of robust archiving solutions.

Disproportionality Analysis and Causal Inference in Drug Safety.

Disproportionality analysis is a method of safety signal detection based on quantitative analysis of spontaneous reports of adverse events. Disproportionality findings are often presented in medical publications as real-world evidence on drug safety. In this paper, we review theoretical properties of disproportionality analysis in the framework of causal inference theory. We show that measures of disproportionality can approximate the causal rate ratio for a specific drug-event combination when the study drug and the set of comparator drugs satisfy all of the following conditions: (1) there is no uncontrolled confounding for the drug-event association of interest, (2) under-reporting for the event of interest is either absent or has the same relative magnitude for the study drug and for the comparator drugs, and (3) reporting rates for all adverse events combined are the same for the study drug and for the comparator drug set. Because these conditions are typically not even approximately satisfied in practice, the overwhelming majority of disproportionality hits represent statistical noise rather than causal associations. Researchers choosing to report disproportionality findings in publications should explicitly acknowledge all key assumptions and the exploratory nature of this data-mining technique.

Chronic Obstructive Pulmonary Disease Outcomes Among Individuals in Japan Who Switched to Heated Tobacco Products Compared to Those Who Continued Smoking or Formerly Smoked Combustible Cigarettes: Protocol for a Real-World Retrospective Study.

Chronic obstructive pulmonary disease (COPD) is a debilitating respiratory disease that is highly associated with smoking. Despite widespread knowledge of the health risks of smoking, many patients with COPD continue to smoke. Growing evidence suggests that alternatives to combustible cigarettes (CIG), such as heated tobacco products (HTP), may be less harmful. To evaluate the impact of switching from CIG to HTP on the time to subsequent COPD exacerbations in patients who have had a COPD-related hospitalization. This retrospective cohort study will be conducted in Japan using electronic health data and tobacco exposure data from questionnaires and consumer databases. The study will invite approximately 30,000 patients who had a COPD-related hospitalization between May 2016 and December 2022. The first of these hospitalizations will be considered a patient's study Index Event. The primary outcome is the time from Index Event to subsequent COPD exacerbation (a composite outcome of subsequent COPD-related hospitalization and all-cause mortality); patients will be observed until March 2025. The primary exposure groups are HTP use and CIG use, respectively, pre- and post-index. We will use weighted Cox proportional hazard models, with propensity score weighting to balance potential confounders, to compare the primary outcome between the primary exposure groups. We will also compare the primary outcome between exclusive HTP users and ancillary exposure groups of dual users of CIG and HTP and former CIG smokers. Secondary outcomes include all-cause mortality, pneumonia-related hospitalization, COPD-related hospitalizations, and all-cause hospitalizations and will be assessed in primary and ancillary exposure groups. The study described in this protocol intends to assess whether there is a longer time to subsequent COPD hospitalizations and all-cause mortality for HTP users compared to CIG smokers. This protocol describes the first large-scale study that will identify patients with COPD from a nationally representative healthcare database and evaluate the history of tobacco product usage from multiple sources. Additionally, this study protocol is the first in the tobacco medical literature that embraces real-world data providing information on HTP use from various tobacco product exposure sources. This will also be the first study to assess the relationship between HTP use and mortality in this patient population. Given the limited evidence on the health effects of HTP in COPD, the results of this study will provide real-world insights into the effects of switching to HTP use compared to continued CIG smoking in patients with COPD. Not applicable.

Diabetes, periodontal disease, and novel therapeutic approaches- host modulation therapy

Diabetes mellitus is a much-studied disorder, characterized by hyperglycemia and numerous oral and medical complications. The latter includes (above all) decreased life-span — and these are widely discussed in the dental and medical literature. The oral complications include impaired wound healing; increased severity of periodontal disease and peri-implantitis; dry mouth (xerostomia); and dental caries. The relationship between diabetes and oral health is bi-directional: Optimal management of local oral disease can profoundly affect the systemic metabolic control of the diabetic patient, and strict management of the patient’s hyperglycemia can reduce its impact on oral disease. The only host modulation therapy (HMT), approved by the U.S. Food and Drug Administration (FDA) to treat periodontal disease, is a novel NON-antimicrobial (low-dose) formulation of doxycycline (Periostat®; 20 mg b.i.d). A publication in Scientific Reports (2017), which supported the clinical rationale of efficacy and safety of low-dose doxycycline in diabetics, stated: “doxycycline not only ameliorated insulin resistance, fasting blood glucose, and insulin levels, and lipid profiles in the circulation and liver, but also improved islet morphology and increased glucose-stimulated insulin secretion.” Additional developments include the biphenolic chemically-modified curcumins, as HMT for managing oral diseases. A lead compound, chemically-modified curcumin 2.24 (CMC2.24), has demonstrated safety and efficacy in vitro, in cell culture, and in vivo using mouse, rat, rabbit, and dog models of disease. In conclusion, novel host-modulation compounds have shown significant promise as adjuncts to traditional local therapy in the clinical management of periodontal and other oral diseases.

Therapeutic Potential of Psychedelics for Treating Anosmia: An Investigation of Online Accounts

ABSTRACT Olfactory dysfunction (OD) has become increasingly prevalent since the COVID-19 pandemic, yet effective treatments remain limited. In recent years, anecdotal reports have emerged on the potential benefits of serotonergic psychedelics (lysergic acid diethylamide [LSD], psilocybin, etc.) in improving OD. To date, only one case series in the medical literature has documented this phenomenon. This study aimed to explore the potential therapeutic effects of psychedelics on OD by conducting a thematic analysis of online posts from people with self-reported OD discussing whether psychedelic use affected their OD. We analyzed 125 online posts, extracting key demographic data, anosmia cause, psychedelic type, psychedelic dosage, and reported impact on olfactory function. 108 posts (86.4%) reported improvements in smell following psychedelic use. Among those reporting improvement, 55 (50.1%) first noticed smell enhancement during their psychedelic experience, and 42 (38.8%) reported olfactory improvements persisting at least one day post-psychedelic use. No statistical relationship was identified between duration of benefit and dose for either psilocybin or LSD. These exploratory findings highlight the need for further research to determine whether serotonergic psychedelics could serve as a viable clinical treatment for OD or facilitate the development of new therapies, if the mechanisms behind these reported improvements can be elucidated.