Pharmaceutical Therapy Research Articles

Effectiveness of pharmaceutical care for improving medication‐related quality of life and adherence to treatment among people living with schizophrenia: a randomised controlled trial

AbstractBackgroundPeople living with schizophrenia frequently exhibit poor medication adherence because of adverse drug reactions (ADRs) or lack of disease awareness. This prospective randomised controlled trial investigated the benefits of pharmaceutical care delivered by hospital pharmacists for improving pharmacotherapy‐related quality of life and medication adherence among this patient group.AimThe purpose of this study was to evaluate the effectiveness of pharmaceutical care interventions in enhancing medication adherence and improving the quality of life of people living with schizophrenia.MethodData were collected during inpatient and subsequent outpatient treatment from 6 January–8 June 2021. Participants were divided into two groups via block randomisation: a control group receiving standard treatment; and an intervention group receiving pharmaceutical care combined with standard treatment. The pharmaceutical care comprised medication review, monitoring of drug‐related problems (including ADRs), adjustment of the dose of antipsychotic medicines in collaboration with psychiatrists, and counselling of participants and caregivers about disease management before discharge. Pharmacotherapy‐related quality of life was assessed using the short version of the Patient‐Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT‐QoL), whereas medication adherence was evaluated using the Medication Taking Behaviour in Thai Patients (MTB‐Thai). The primary outcomes were the average change in the PROMPT‐QoL score from inpatient to outpatient care and the average outpatient MTB‐Thai score. Ethical approval was granted by the Srithanya Hospital Office of the Ethics Commission for Human Research (Reference no: STY.COA008/2564) and the study conforms to the Declaration of Helsinki. Informed consent was obtained from all patient and caregiver participants via a project information sheet and the completion of a written consent form.ResultsAt the end of the study, compared with the control group, the intervention group exhibited a significantly lower ADR prevalence (57.90% vs 79.70%, p < 0.05) and a greater change in the mean PROMPT‐QoL scores pertaining to ‘obtaining information of medicines and diseases’, ‘impact of medicine side effects’, ‘ease of use of medicines’, and ‘therapeutic relationship’. In addition, the intervention group achieved a significantly higher mean of medicine adherence score than the control group (22.81 ± 1.61 vs 16.85 ± 3.00, p < 0.001).ConclusionPharmaceutical care may improve the outcomes of people living with schizophrenia by improving their quality of life, decreasing ADRs, and enhancing medication adherence.

Empowering Minds and Bodies: The Impact of Exercise on Multiple Sclerosis and Cognitive Health.

Multiple sclerosis (MS) is a global health concern affecting around 2.6 million people. It is characterised by neural inflammation, myelin breakdown and cognitive decline. Cognitive impairment, especially reduced cognitive processing speed (CPS), which affects up to 67% of MS patients and frequently manifests before mobility concerns, is one of the disease's most serious side effects. Effective adaptation and the application of cognitive rehabilitation treatments depend on the early diagnosis of cognitive impairment. Although pharmaceutical therapies have some drawbacks, endurance training has become a promising alternative. Intensity-controlled endurance exercise has the ability to delay the onset of MS symptoms and enhance cognitive function. Exercise has also been shown to have neuroprotective effects in a number of neurological disorders, including MS, Parkinson's disease and stroke. This includes both aerobic and resistance training. A mix of aerobic exercise and weight training has shown promise, especially for people with mild cognitive impairment, but according to recent studies any amount of physical activity is beneficial to cognitive performance. In conclusion, this in-depth analysis highlights the crucial part endurance exercise plays in treating MS-related cognitive impairment. It improves not only neurological health in general but also cognitive performance. Exercise can help control MS in a way that dramatically improves quality of life and well-being.

The role of oxidative stress and inflammation biomarkers in pre- and postoperative monitoring of prostate cancer patients

Introduction Prostate Cancer (PC) is a global health concern affecting men worldwide. Oxidative stress is believed to contribute to the initiation of early-stage PC lesions. Additionally, inflammation has long been acknowledged as a factor in the development of PC. We aimed to examine the biomarkers of oxidative stress and inflammation in PC patients before and after surgery. Patients and methods A cross-sectional study was conducted at the Urology Outpatient Clinic of Bezmialem Vakif University Hospital. A total of 150 individuals were included in the study, divided into five groups: 50 Healthy controls, 25 patients with Benign Prostatic Hyperplasia (BPH), 25 patients with Low-Risk Prostate Cancer (LRPC), 25 patients with Medium-Risk Prostate Cancer (MRPC), and 25 patients with High-Risk Prostate Cancer (HRPC). Measurements of Total Oxidant Status (TOS), Total Antioxidant Status (TAS), Total Thiol (TT), and Native Thiol (NT) were performed using photometric methods. Oxidative Stress Index (OSI) and Disulfide (DIS) levels were calculated mathematically. Levels of Interleukin-10 (IL-10), Interleukin-1beta (IL-1β), Tumor Necrosis Factor-alpha (TNF-α), Interleukin-6 (IL-6), and Presepsin were determined using commercially available enzyme-linked immunosorbent assay (ELISA) kits. Results Compared to the healthy control group, the results indicated a statistically significant increase in both oxidative stress and inflammation levels. In the groups receiving both pharmaceutical therapy and surgical treatment (PC), a significant decrease in oxidative stress and inflammation levels was observed. Conclusion Consequently, it is suggested that the assessment of oxidative stress and inflammatory biomarkers should be incorporated in the pre- and postoperative monitoring of patients with PC.

The Current Landscape of Pharmacotherapies for Sarcopenia.

Sarcopenia is a skeletal muscle disorder characterized by progressive and generalized decline in muscle mass and function. Although it is mostly known as an age-related disorder, it can also occur secondary to systemic diseases such as malignancy or organ failure. It has demonstrated a significant relationship with adverse outcomes, e.g., falls, disabilities, and even mortality. Several breakthroughs have been made to find a pharmaceutical therapy for sarcopenia over the years, and some have come up with promising findings. Yet still no drug has been approved for its treatment. The key factor that makes finding an effective pharmacotherapy so challenging is the general paradigm of standalone/single diseases, traditionally adopted in medicine. Today, it is well known that sarcopenia is a complex disorder caused by multiple factors, e.g., imbalance in protein turnover, satellite cell and mitochondrial dysfunction, hormonal changes, low-grade inflammation, senescence, anorexia of aging, and behavioral factors such as low physical activity. Therefore, pharmaceuticals, either alone or combined, that exhibit multiple actions on these factors simultaneously will likely be the drug of choice to manage sarcopenia. Among various drug options explored throughout the years, testosterone still has the most cumulated evidence regarding its effects on muscle health and its safety. A mas receptor agonist, BIO101, stands out as a recent promising pharmaceutical. In addition to the conventional strategies (i.e., nutritional support and physical exercise), therapeutics with multiple targets of action or combination of multiple therapeutics with different targets/modes of action appear to promise greater benefit for the prevention and treatment of sarcopenia.

Cost-effectiveness of Dementia Medication

Aim:: This review has examined and organized the available research on dementia medication care costs. Although the accessible database in this area is growing and is still quite limited, there are many clear scientific methods. Objective:: The use of Memantine, a non-competitive antagonist with low to moderate affinity for the NMDA (N-methyl-D-aspartate) receptor, has been approved for the treatment of mild to moderately severe Alzheimer's disease (AD). The efficacy of cholinesterase inhibitors (ChEIs) in the treatment of dementia varies depending on the drug type and ease of administration. Numerous techniques have been employed to evaluate the quality of life (QOL) of individuals suffering from dementia. QOL data is a well-established measure of an intervention's effectiveness. Up to now, cost-effectiveness studies have concentrated on both pharmaceutical and non-pharmacological therapy. Each unit of QoL-AD improvement costs USD27.82578 at mean values. Methods:: Searches were conducted to observe studies of the pharmacoeconomic impact of dementia medications with the help of previous articles published in journals and collected from Google Scholar with name search dementia or Alzheimer's cross-referenced with pharmacoeconomic or costs and effectiveness.

The Complex Mechanisms and the Potential Effects of Statins on Vascular Calcification: A Narrative Review.

Vascular calcification (VC) is a complex process of calcium deposition on the arterial wall and atherosclerotic plaques and involves interaction between vascular smooth muscle cells, inflammatory and VC mediators. The latter are independent predictors of cardiovascular morbidity and mortality and potential targets of pharmaceutical therapy. This paper is a narrative review of the complex mechanisms of VC development and in this context the potential anti-atherosclerotic effects of statins. At the initial stages of atherosclerosis VC correlates with atherosclerosis burden and in the long-term with cardiovascular morbidity and mortality. A plethora of animal and clinical studies have proposed statins as the cornerstone of primary and secondary prevention of atherosclerotic cardiovascular disease. Based on coronary computed tomography data, high doses of statins may have negligible or even positive effects on the progression of coronary artery calcification. Growing data support an increase in atherosclerotic plaque calcification in peripheral arteries (e.g., carotids), after long-term, statin-therapy. Despite the paradox of increasing VC, those effects of statins have been associated with higher plaque stability, reducing the risk of consequent adverse events. Statins seem to promote a "favorable" atherosclerotic calcification, suppressing atherosclerotic lesion expansion and their vulnerability. More studies are required to clarify the underlying mechanisms.

PROFILE OF BRONCHIAL ASTHMA PATIENTS AT A PULMONARY OUTPATIENT CLINIC OF A TERTIARY HOSPITAL IN INDONESIA

Highlights: Budesonide-Formoterol was the most commonly prescribed medication for controlling and relieving symptoms in most individuals with bronchial asthma. Most patients reported good control of their asthma, and most also reported no subjective problems. Abstract Background: Bronchial asthma is a common disease affecting the patient's quality of life and impacting daily life. The incidence of asthma is increasing in many countries around the world, although hospitalization and death rates due to asthma have decreased. Objective: This study aimed to explain the sociodemographic (age, sex, body mass index, smoking status) and clinical (comorbidities, subjective complaints, asthma control status, pharmacological therapy, and pharmaceutical step therapy) characteristics of bronchial asthma patients at the Pulmonary Outpatient Clinic the Universitas Airlangga Hospital, Surabaya, Indonesia. Material and Method: An analytic observational study with retrospective cross-sectional research was conducted from December 2021 to January 2023 using secondary data in medical records with total sampling as the sampling technique. Result: From 70 cases, 35 patients made the three-times visits. The majority of these patients who met the inclusion criteria were female (78.6%), 50 to 59 years old (27.1%), had class 1 obese (38.6%), non-smokers (77.1%), and had no comorbidities (28.6%). On the first, second, and third visits, the patients had no subjective complaints, had well-maintained asthma status control, used controllers and relievers in the form of Budesonide-Formoterol, and did not receive additional therapy. They had step therapy in the category of preferred controllers and relievers, steps 1–2. Conclusion: The majority of bronchial asthma patients at Universitas Airlangga Hospital, Surabaya, Indonesia, were female, aged 50–59 years, non-smokers, obese class 1, had no subjective complaints, well-controlled asthma, preferred controllers and relievers steps 1–2, using Budesonide-Formoterol as controller and reliever therapy, and did not receive additional therapy.

Age-Related Orthostatic Hypotension: A Comprehensive Analysis of Prevalence, Mechanisms, and Management in the Geriatric Population.

Geriatric patients frequently encounter orthostatic hypotension (OH), a multifaceted condition characterized by a significant drop in blood pressure upon assuming an upright position. As the elderly population is particularly susceptible to OH, our review endeavors to comprehensively explore the complex nature of this condition and various factors contributing to its development. We investigate the impact of comorbidities, polypharmacy, age-related physiological changes, and autonomic dysfunction in the pathogenesis of OH. Geriatric patients with OH are faced with an elevated risk of falls, syncope, a decline in their overall quality of life, and hence increased mortality. These implications require careful consideration, necessitating a thorough examination of therapeutic strategies. We evaluate various pharmaceutical and nonpharmacological therapies, delving into the effectiveness and safety of each approach in managing OH within geriatric populations. We explore the role of pharmacotherapy in alleviating symptoms and mitigating OH-related complications, as well as the potential benefits of volume expansion techniques to augment blood volume and stabilize blood pressure. We place particular emphasis on the significance of lifestyle changes and nonpharmacological interventions in enhancing OH management among the elderly. These interventions encompass dietary modifications, regular physical activity, and postural training, all tailored to the unique needs of the individual patient. To optimize outcomes and ensure patient safety, we underscore the importance of individualized treatment plans that take into account the geriatric patient's overall health status, existing comorbidities, and potential interactions with other medications. This review aims to improve clinical practice and patient outcomes by advocating for early detection, properly tailored management, and targeted interventions to address OH in the elderly population. By raising awareness of OH's prevalence and complexities among healthcare professionals, we hope to foster a comprehensive understanding of OH and contribute to the overall wellness and quality of life of this vulnerable demographic.

"Keep trying": a qualitative investigation into what patients with chronic pain gain from Project ECHO.

The study aims to investigate the patient perspective on the pathway from healthcare practitioners' presentations of their cases at a Project ECHO (Extension for Community Healthcare Outcomes) tele-clinic to the management of those patients' chronic pain. Managing patients with chronic and complex pain constitutes a prevalent, stressful challenge in the primary care setting. Primary care physicians typically have received little training in treating such patients and, until recently, have relied heavily on opioid and other pharmaceutical therapies as part of their regimen. Project ECHO Ontario Chronic Pain and Opioid Stewardship is an interprofessional telementoring program connecting pain specialists to primary care practitioners with the aim of supporting them in managing their patients with chronic pain, although the patients concerned do not generally participate in the telementoring sessions. While a number of papers have described the benefits accruing to healthcare professionals through participating in Project ECHO, there has been little exploration concerning patients' perceptions of their care subsequent to case presentation. Using data from in-depth interviews with 20 patients along with their associated case presentation forms and the recommendations following the presentation, we look at the alignment of patient and practitioner views and inquire about the patient's perceptions of how Project ECHO affects them. Results suggest that the impact on patients is indirect but positive: most respondents express pleasure in contributing to research around chronic pain management, though only two of them identified a direct impact on their own treatment. They also appreciated their practitioner's efforts to bring expert attention to the patient's situation. Patients whose cases are presented to Project ECHO sessions experience positive emotions at being part of the process of research and quality improvement, regardless of changes in their own conditions. This study highlights the importance to patients of their practitioners' commitment to managing their chronic pain.

Force Control Issues in Upper and Lower Limbs in Parkinson's Disease and Freezing of Gait.

Parkinson's Disease (PD) has been found to cause force control deficits in upper and lower limbs. About 50% of patients with advanced PD develop a debilitating symptom called freezing of gait (FOG), which has been linked to force control problems in the lower limbs, and some may only have a limited response to the gold standard pharmaceutical therapy, levodopa, resulting in partially levodopa-responsive FOG (PLR-FOG). There has been limited research on investigating upper-limb force control in people with PD with PLR-FOG, and without FOG. In this pilot study, force control was explored using an upper-and-lower-limb haptics-enabled robot in a reaching task while people with PD with and without PLR-FOG were on their levodopa medication. A healthy control group was used for reference, and each cohort completed the task at three different levels of assistance provided by the robot. Similar significant proportional force control deficits were found in the upper and lower limbs in patients with PLR-FOG versus those without FOG. Some aspects of force control were found to be retained, including an ability to increase or decrease force in response to changes in resistance while completing a reaching task. Overall, these results suggest there are force control deficits in both the upper and lower limbs in people with PLR-FOG.

Intelligent Insights for Noninvasive Aortic Valve Stenosis therapeutics

Stagnation of therapeutic options is a prominent feature of valvular aortic stenosis(AS). Invasive therapeutic options in the form of open heart aortic valve surgery or transcatheter aortic valve implantation (TAVI) are still the only therapeutic options until the moment. Decoding the mystery of AS morphogenesis is a challenging endeavor. It is only possible by multidisciplinary approach emanating from epidemiological back ground. Eagle eye observations of clinical correlates as well as prudent research in the molecular , genetic and epigenetic arena targeting decoding the genesis involved in bicuspid aortic valve formation are critical demands to throw stone in the stagnant lake. Hybrid pharmaceutical therapies combined with effective physical therapies will pave the way for future breakthroughs targeting noninvasive therapeutic options for valvular aortic stenosis or even aborting the disease in human species.

Emerging pharmaceutical therapies for targeting cholangiocarcinoma microenvironment and chemokine pathways

Emerging pharmaceutical therapies for targeting cholangiocarcinoma microenvironment and chemokine pathways

Chronobiology of the Tumor Microenvironment: Implications for Therapeutic Strategies and Circadian-Based Interventions.

Numerous research works have emphasized the critical role that circadian rhythm plays in the tumor microenvironment (TME). The goal of clarifying chrono-pharmacological strategies for improving cancer treatment in clinical settings is a continuous endeavor. Consequently, to enhance the use of time-based pharmaceutical therapies in oncology, combining existing knowledge on circadian rhythms' roles within the TME is essential. This perspective elucidates the functions of circadian rhythms in the TME across various stages of cancer development, progression, and metastasis. Specifically, aging, angiogenesis, and inflammation are implicated in modulating circadian rhythm within the TME. Furthermore, circadian rhythm exerts a profound influence on current cancer treatments and thereby generates chronotheray to manage tumors. From a TME perspective, circadian rhythm offers promising opportunities for cancer prevention and treatment; nevertheless, further study is needed to address unanswered scientific problems.

Effects of an intervention combining physical activity and components of Amygdala and Insula Retraining (AIR) on sleep and working memory among older male adults

<sec><title>Background</title><p>Older individuals are at a particular risk of sleep disorders, a loss of cognitive and emotional control, and a poor quality of life. Pharmaceutical therapy for these conditions is commonplace but has not been particularly effective, and relatively little research exists for their treatment using non-pharmacological approaches. The effectiveness of Physical Activity plus selected components of Amygdala and Insula Retraining (PAAIR) was tested to improve sleep quality, depression, working memory, and emotion regulation among older males.</p></sec><sec><title>Methods</title><p>This was a parallel, randomized control trial. The study was conducted in-person among 40 older Iranian men (<italic>M</italic><sub>age</sub>: 65.78, <italic>SD</italic> = 2.41). The participants were randomly assigned with equal allocation to either the PAAIR or a control condition. Both interventions were conducted in-person over 12 weeks. The participants met twice weekly for 45-minute sessions at a local elderly training and rehabilitation center. All participants completed measurements for sleep quality, depressive symptoms, working memory, and emotion regulation at baseline, 12 weeks (immediately after the intervention), and 8 weeks later.</p></sec><sec><title>Results</title><p>Among the 36 individuals who finished the study, their sleep quality, working memory, and emotion regulation improved, and their depressive symptoms were reduced from baseline to 12 weeks (post-intervention) and 8 weeks later; these effects were seen even more so for the PAAIR group compared to the control group, with large to extremely large effect sizes.</p></sec><sec><title>Conclusion</title><p>The findings suggest that PAAIR has the potential to enhance sleep quality, cognitive function, and emotion regulation and reduce depressive symptoms among older men, thus contributing to their quality of life and mental health.</p></sec>

Economic Impact of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Italy. Analysis and Perspectives.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a multisystem condition destined to become pandemic in the coming decades. This study aimed at evaluating the economic impact of MASLD in the Italian population from the Italian National Healthcare Service (NHS) perspective. The economic impact of the MASLD was assessed by developing a calculation model in Microsoft Excel® from the Italian NHS perspective, considering healthcare resources and direct costs. The target population was based on the prevalence data. Through a literature search, complications of MASLD were identified, including MASH, with relative risk of evolution into CC, DCC, HCC, T2DM, cardiovascular diseases, in particular AMI and stroke, CKD, and CRC. The differential impact between complication development in the population with MASLD and the same sample size population without-MASLD was evaluated. Differential risk data, mortality rates, and event unit costs were drawn from the published international literature. Frequency and cost data were applied to the total target population, the total annual costs and mortality data, referring to the two arms, were then calculated, and the differential value was obtained. Based on an estimated 11,546,370 MASLD target population, an annual illness impact of €12,251,631,822 was calculated, corresponding to a difference of €7,731,674,054 compared with the same sample size without MASLD. Moreover, the MASLD population is expected to experience 13,438 additional deaths annually. The growing epidemiological impact of MASLD and its complications represent a huge economic burden for healthcare services worldwide. An integrated approach, including changes in lifestyle behaviors, will be the first step. Specific drugs for MASLD are not yet available; however, studies are underway, and combined pharmaceutical therapies may be an inevitable choice to achieve adequate control of MASLD and its complications.

Low Urbanization but Not Illiteracy was Associated with Poor Medication Adherence among Elderly People in Rural Taiwan

Most elderly persons suffer from chronic diseases. To treat chronic diseases, good medication adherence and refilling medication as physicians’ advice are key points of pharmaceutical therapy. However, the literature revealed that only limited studies have focused on the medication adherence of the elderly in rural communities. This study evaluated the adherence to medication and the degree of refilling prescriptions as physician’s advice by the Adherence to Refills and Medications Scale (ARMS) and evaluated the factors associated with poor adherence to medication. This cross‐sectional study focused on the medication use of the elderly population in rural areas in western Taiwan and analyzed related personal and social factors which influence the behaviors of pharmaceutical therapy. In conclusion, most of the elderly who lived in rural areas in western Taiwan have poor adherence (ARMS score over 12) to medication and a poor degree of refilling prescriptions as per physicians’ advice. Moreover, age ≥75 years and low urbanization were significantly associated with poor adherence. Future research is warranted to assess the effect of the interventions to improve medication adherence on chronic disease control, disability, and mortality.

The role of postoperative trimetazidine therapy in on-pump coronary artery bypass surgery.

Coronary artery bypass surgery remains the gold standard in the treatment of patients with ischemic heart disease. However, the increased oxidative stress caused by the release of free radicals during the ischemia-reperfusion time is a well-known pathophysiological process during and after coronary revascularization procedures. It may lead to reversible and irreversible myocardial injury.

Identification of oxidative stress-related genes associated with immune cells in Aortic Valve Stenosis based on bioinformatics analysis.

Aortic valve stenosis (AS) is the most common clinical valvular heart disease. Without effective pharmaceutical therapy at present, identifying effective therapeutic targets is critical. However, the pathological and molecular mechanisms of aortic stenosis are complex, including inflammatory infiltration, oxidative stress and so on. In this study, we investigated how oxidative stress interacts with immune cell infiltration in aortic stenosis using bioinformatics analysis, and provide a better understanding of aortic valve stenosis at the pathophysiologic level. After obtaining the datasets, including GSE153555, GSE51472 and GSE12644, from the Gene Expression Omnibus (GEO) database, the package 'limma' was applied to identify the differentially expressed genes (DEGs) in GSE153555. The GeneCards database searched for oxidative stress-related genes. We evaluated the expression of 22 immune cells using Cibersort. Clustering differentially expressed genes into different modules via Weighted gene correlation network analysis (WGCNA) and exploring the relationship among modules and immune cell types. The genes in modules intersected with oxidative stress-related genes to find oxidative stress genes related to immune infiltration. Finally, the GSE51472 and GSE12644 datasets were used to initially verify oxidative stress-related genes in aortic valve stenosis. A total of 1213 differentially expressed genes were identified in the GSE153555 dataset, and 279 of them were oxidative stress-related genes. Increased infiltration of B cell navie and Macrophages M1 in aortic stenosis was found. Using WGCNA, we clustered 15 modules. The brown module was identified as the most significant template positively correlated with T-cell regulatory Treg, and the magenta module was identified as a critical module associated with M1 macrophages with the highest negative correlation coefficient. The results verified by other datasets showed that in comparison to normal people, the aortic stenosis patients exhibited dramatically high IGFBP2 and SPHK1 expression. Both IGFBP2 and SPHK1 may be significantly involved in the mechanism of aortic stenosis pathophysiologically and can be used for aortic stenosis early detection, therapy, and therapeutic targets.

Analysis of Pharmaceutical Therapies for Primary Headache

Primary headaches, secondary headaches, neuropathies and facial pains, and other headaches are the four types of headache disorders, in which primary headache disorder includes migraine, cluster headache, tension-type headache, and new daily persistent headache. Pathologies of migraine and cluster headaches are still unclear but possible explanations are proved to be related to trigeminal neurons, calcitonin gene-related peptide (CGRP) release, and neuroinflammation. This research listed these possible explanations and summarized the basic factors of migraine and cluster headache attacks. Based on the pathologies, various choices of therapies were introduced. This research mentioned typical pharmaceutical therapies for headaches, including nonsteroidal anti-inflammatory drugs, paracetamol, 5-HT1 receptor agonists involving triptan and dihydroergotamine mesylate, opioids, caffeine, and botulinum toxin. Furthermore, new medications in recent studies, including CGRP antagonists and caffeine were noticed as well. Related reliable mechanisms and side effects of all these drugs were highlighted in this review. Realizing the pros and cons of current treating medications is significant for better understanding on mechanism of headaches and designing more effective drugs in order to offer better promise on treating therapies.

The implication of infection with respiratory syncytial virus in pediatric recurrent wheezing and asthma: knowledge expanded post-COVID-19 era.

Respiratory syncytial virus (RSV) infection has been identified to serve as the primary cause of acute lower respiratory infectious diseases in children under the age of one and a significant risk factor for the emergence and development of pediatric recurrent wheezing and asthma, though the exact mechanism is still unknown. In this study, we discuss the key routes that lead to recurrent wheezing and bronchial asthma following RSV infection. It is interesting to note that following the coronavirus disease 2019 (COVID-19) epidemic, the prevalence of RSV changes significantly. This presents us with a rare opportunity to better understand the associated mechanism for RSV infection, its effects on the respiratory system, and the immunological response to RSV following the COVID-19 epidemic. To better understand the associated mechanisms in the occurrence and progression of pediatric asthma, we thoroughly described how the RSV infection directly destroys the physical barrier of airway epithelial tissue, promotes inflammatory responses, enhances airway hyper-responsiveness, and ultimately causes the airway remodeling. More critically, extensive discussion was also conducted regarding the potential impact of RSV infection on host pulmonary immune response. In conclusion, this study offers a comprehensive perspective to better understand how the RSV infection interacts in the control of the host's pulmonary immune system, causing recurrent wheezing and the development of asthma, and it sheds fresh light on potential avenues for pharmaceutical therapy in the future.