New once daily mesalamine formulations may improve adherence to medication usage.Response to Asacol and other forms of 5-aminosalicyclic acid(5-ASA)is better correlated with tissue concentrations and best predicted by...New once daily mesalamine formulations may improve adherence to medication usage.Response to Asacol and other forms of 5-aminosalicyclic acid(5-ASA)is better correlated with tissue concentrations and best predicted by concentrations of the drug within the lumen of the colon.Our group used computer simulation to predict colonic 5-ASA levels after Asacol administration.In our study,the model simulated Asacol distribution in the healthy colon,and during quiescent and active ulcerative colitis.An Asacol dosage of 800 mg,threetimes a day,was compared to 2400 mg given once a day.Under ideal conditions,the predicted maximum drug in the total colon and individual colonic segments over 100 d differed by less than 3%between single and multiple doses.Despite changes in motility and defection rates,the predicted maximum and average 5-ASA concentrations in the total colon and individual colonic segments differed by less than 10%between dosing regimens.Asymmetric distribution of 5-ASA in the colon was influenced by frequency of bowel movements and colonic transit rate.In active colitis,sigmoid 5-ASA concentration becomes negligible.Our model supports once daily administration of Asacol as standard treatment for ulcerative colitis.展开更多
The Chandipura vesiculovirus(CHPV),a single-stranded,negative sense RNA arbovirus with five structural proteins-the G,N,M,P,and L proteins-is the source of Chandipura virus infection.Children between the ages of 9 mon...The Chandipura vesiculovirus(CHPV),a single-stranded,negative sense RNA arbovirus with five structural proteins-the G,N,M,P,and L proteins-is the source of Chandipura virus infection.Children between the ages of 9 months and 14 years old are the most common recipients of CHPV infection,which is primarily spread by sand flies(Sergentomyia,Phlebotomus species).The potential advantages of black seeds(N.sativa)in the treatment of patients with CHPV infection are the main topic of our current review.The majority of patients infected with CHPV experience neurological complications such as encephalitis and other neurological complications.Since there is currently no approved antiviral treatment,supportive care and symptomatic therapy are the primary methods used to manage CHPV-infected patients.Herbal candidates possessing antioxidant,immunomodulatory,antiviral,and anti-inflammatory qualities may aid in the treatment of CHPV infection.The antiviral,anti-inflammatory,antioxidant,and immunomodulatory qualities of black seeds(N.sativa)have been shown in a number of preclinical and clinical investigations;these attributes could be helpful in the treatment of CHPV infection.Black seeds(N.sativa)may help treat CHPV-infected patients in the early stages of their illness when used in conjunction with symptomatic therapy and supportive care.In patients infected with CHPV,additional randomized controlled clinical trials would assess the efficacy and safety of black seeds(N.sativa).展开更多
Identifying the presence of cognitive impairment in patients admitted for inpatient rehabilitation is important as it may impact on their ability to participate in a rehabilitation program. The Folstein Mini Mental St...Identifying the presence of cognitive impairment in patients admitted for inpatient rehabilitation is important as it may impact on their ability to participate in a rehabilitation program. The Folstein Mini Mental State Examination (MMSE) has been used by clinicians as a cognitive screening tool for its convenience, even though it is not sensitive, and often fails to detect cognitive impairment. Recently, the Montreal Cognitive Assessment (MoCA) has been developed as a brief cognitive screening tool to detect mild-moderate cognitive impairment. We performed a longitudinal study to compare the utility of the MMSE and MoCA in an inpatient rehabilitation setting. A total of 50 consecutive patients were studied with an average age of 71.7 years of age. The mean test score for MMSE was 26.5 and 22.2 for the MoCA. The Pearson’s correlation coefficient between the scores was 0.695 (p < 0.003). The mean performance time for the MMSE was 7.4 minutes and 14.8 minutes for the MoCA. MMSE did not perform well as a screening instrument for mild cognitive impairment as there were 43 patients who scored 24 or more on MMSE, and 25 patients (58%) scored 25 or less on MoCA, indicating the presence of cognitive impairment. Even though the MoCA takes longer to administer, the additional important information provided indicates that the MoCA should be used rather than the MMSE as a cogni-tive screening tool.展开更多
Casals et al have reported an inverse correlation between serum phosphate and body weight after administration of sodium phosphate at a dose of 60 g. Our group has already described the relationship between body weigh...Casals et al have reported an inverse correlation between serum phosphate and body weight after administration of sodium phosphate at a dose of 60 g. Our group has already described the relationship between body weight and hyperphosphatemia with these preparations, although our study was not quoted by Casals. We performed a pharmacokinetic study involving 13 volunteers who were divided into two groups on the basis of body weight： group I consisting of seven women with a median weight of 60 kg and group Ⅱ consisting of five men and one woman with a median weight of 119.2 kg. Group Ⅰdeveloped higher peak phosphate levels and maintained these levels above the subjects in Group Ⅱ for a prolonged time period despite adequate hydration being ensured with frequent monitoring of weight, fluid intake and total body weight. Our studydemonstrated that adequate hydration does not protect against the secondary effects of hyperphosphatemia. In the study by Casais et al, 66% of the study subjects were women, the correlation between serum phosphate and gender in their data also appears to be important. Women are at higher risk of acute phosphate nephropathy due to a diminished volume of distribution of the high dose of ingested phosphate. Decreased volume of distribution in women is due to diminished body weight. This is further compounded by decreased creatinine clearance in females.展开更多
Primary sclerosing cholangitis(PSC)is a chronic,progressive,hepatobiliary disease characterized by inflammation and fibrosis of the intra-and extra-hepatic bile ducts.Its natural history is one that generally progress...Primary sclerosing cholangitis(PSC)is a chronic,progressive,hepatobiliary disease characterized by inflammation and fibrosis of the intra-and extra-hepatic bile ducts.Its natural history is one that generally progresses towards cirrhosis,liver failure,cholangiocarcinoma,and ultimately disease-related death,with a median liver transplantation-free survival time of approximately 15-20 years.However,despite its lethal nature,PSC remains a heterogenous disease with significant variability in outcomes amongst different regions of the world.There are also many regions where the outcomes of PSC have not been studied,limiting the overall understanding of this disease worldwide.In this review,we present the geoepidemiologic variations in outcomes of PSC,with a focus on survival pre-and post-liver transplantation as well as the concurrence of inflammatory bowel disease and hepatobiliary neoplasia.展开更多
文摘New once daily mesalamine formulations may improve adherence to medication usage.Response to Asacol and other forms of 5-aminosalicyclic acid(5-ASA)is better correlated with tissue concentrations and best predicted by concentrations of the drug within the lumen of the colon.Our group used computer simulation to predict colonic 5-ASA levels after Asacol administration.In our study,the model simulated Asacol distribution in the healthy colon,and during quiescent and active ulcerative colitis.An Asacol dosage of 800 mg,threetimes a day,was compared to 2400 mg given once a day.Under ideal conditions,the predicted maximum drug in the total colon and individual colonic segments over 100 d differed by less than 3%between single and multiple doses.Despite changes in motility and defection rates,the predicted maximum and average 5-ASA concentrations in the total colon and individual colonic segments differed by less than 10%between dosing regimens.Asymmetric distribution of 5-ASA in the colon was influenced by frequency of bowel movements and colonic transit rate.In active colitis,sigmoid 5-ASA concentration becomes negligible.Our model supports once daily administration of Asacol as standard treatment for ulcerative colitis.
文摘The Chandipura vesiculovirus(CHPV),a single-stranded,negative sense RNA arbovirus with five structural proteins-the G,N,M,P,and L proteins-is the source of Chandipura virus infection.Children between the ages of 9 months and 14 years old are the most common recipients of CHPV infection,which is primarily spread by sand flies(Sergentomyia,Phlebotomus species).The potential advantages of black seeds(N.sativa)in the treatment of patients with CHPV infection are the main topic of our current review.The majority of patients infected with CHPV experience neurological complications such as encephalitis and other neurological complications.Since there is currently no approved antiviral treatment,supportive care and symptomatic therapy are the primary methods used to manage CHPV-infected patients.Herbal candidates possessing antioxidant,immunomodulatory,antiviral,and anti-inflammatory qualities may aid in the treatment of CHPV infection.The antiviral,anti-inflammatory,antioxidant,and immunomodulatory qualities of black seeds(N.sativa)have been shown in a number of preclinical and clinical investigations;these attributes could be helpful in the treatment of CHPV infection.Black seeds(N.sativa)may help treat CHPV-infected patients in the early stages of their illness when used in conjunction with symptomatic therapy and supportive care.In patients infected with CHPV,additional randomized controlled clinical trials would assess the efficacy and safety of black seeds(N.sativa).
文摘Identifying the presence of cognitive impairment in patients admitted for inpatient rehabilitation is important as it may impact on their ability to participate in a rehabilitation program. The Folstein Mini Mental State Examination (MMSE) has been used by clinicians as a cognitive screening tool for its convenience, even though it is not sensitive, and often fails to detect cognitive impairment. Recently, the Montreal Cognitive Assessment (MoCA) has been developed as a brief cognitive screening tool to detect mild-moderate cognitive impairment. We performed a longitudinal study to compare the utility of the MMSE and MoCA in an inpatient rehabilitation setting. A total of 50 consecutive patients were studied with an average age of 71.7 years of age. The mean test score for MMSE was 26.5 and 22.2 for the MoCA. The Pearson’s correlation coefficient between the scores was 0.695 (p < 0.003). The mean performance time for the MMSE was 7.4 minutes and 14.8 minutes for the MoCA. MMSE did not perform well as a screening instrument for mild cognitive impairment as there were 43 patients who scored 24 or more on MMSE, and 25 patients (58%) scored 25 or less on MoCA, indicating the presence of cognitive impairment. Even though the MoCA takes longer to administer, the additional important information provided indicates that the MoCA should be used rather than the MMSE as a cogni-tive screening tool.
文摘Casals et al have reported an inverse correlation between serum phosphate and body weight after administration of sodium phosphate at a dose of 60 g. Our group has already described the relationship between body weight and hyperphosphatemia with these preparations, although our study was not quoted by Casals. We performed a pharmacokinetic study involving 13 volunteers who were divided into two groups on the basis of body weight： group I consisting of seven women with a median weight of 60 kg and group Ⅱ consisting of five men and one woman with a median weight of 119.2 kg. Group Ⅰdeveloped higher peak phosphate levels and maintained these levels above the subjects in Group Ⅱ for a prolonged time period despite adequate hydration being ensured with frequent monitoring of weight, fluid intake and total body weight. Our studydemonstrated that adequate hydration does not protect against the secondary effects of hyperphosphatemia. In the study by Casais et al, 66% of the study subjects were women, the correlation between serum phosphate and gender in their data also appears to be important. Women are at higher risk of acute phosphate nephropathy due to a diminished volume of distribution of the high dose of ingested phosphate. Decreased volume of distribution in women is due to diminished body weight. This is further compounded by decreased creatinine clearance in females.
文摘Primary sclerosing cholangitis(PSC)is a chronic,progressive,hepatobiliary disease characterized by inflammation and fibrosis of the intra-and extra-hepatic bile ducts.Its natural history is one that generally progresses towards cirrhosis,liver failure,cholangiocarcinoma,and ultimately disease-related death,with a median liver transplantation-free survival time of approximately 15-20 years.However,despite its lethal nature,PSC remains a heterogenous disease with significant variability in outcomes amongst different regions of the world.There are also many regions where the outcomes of PSC have not been studied,limiting the overall understanding of this disease worldwide.In this review,we present the geoepidemiologic variations in outcomes of PSC,with a focus on survival pre-and post-liver transplantation as well as the concurrence of inflammatory bowel disease and hepatobiliary neoplasia.
