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Pastor-Idoate S, Mateos-Olivares M, Sobas EM, Marcos M, Toribio A, Pastor JC, Usategui Martín R. Short-Wavelength Light-Blocking Filters and Oral Melatonin Administration in Patients With Retinitis Pigmentosa: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49196. [PMID: 37971796 PMCID: PMC10690531 DOI: 10.2196/49196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The medical community is beginning to recognize that retinitis pigmentosa (RP), due to its disabling progression, eventually leads to a reduction in the patient´s quality of life, a direct economic impact, and an increase in the burden on the health care system. There is no curative treatment for the origin of the disease, and most of the current interventions fail in reducing the associated negative psychological states, such as anxiety and depression, which lead to increased variability of vision and pose a continuous threat to the patient's independence. OBJECTIVE The aim of this study is to assess the effect of oral melatonin (OM) administration alone and combined with short-wavelength light (SWL)-blocking filters on patients with RP and test their effectiveness in improving the level of stress and sleep problems in many of these patients. METHODS We have developed a low-cost therapy protocol for patients with RP with sleep disorders and negative psychological stress. Patients will be randomized to receive a combined intervention with SWL-blocking filters and OM, SWL-blocking filters alone, or OM alone. There will also be a nonintervention arm as a control group. This study will be conducted across 2 retinal units in patients with RP with sleep disorders and high perceived stress and anxiety score reports. Patients will be assessed in the preintervention period, weekly during the 4 weeks of intervention, and then at 6 months postintervention. The primary outcomes are the differences in changes from baseline to postintervention in hormone release (α-amylase, cortisol, and melatonin) and sleep quality, as measured with the visual analog scale. Secondary outcome measures include clinical macular changes, as measured with optical coherence tomography and optical coherence tomography angiography; retinal function, as measured using the visual field and best-corrected visual acuity; sleep data collected from personal wearables; and several patient-reported variables, such as self-recorded sleep diaries, quality of life, perceived stress, and functional status. RESULTS This project is still a study protocol and has not yet started. Bibliographic research for information for its justification began in 2020, and this working group is currently seeking start-up funding. As soon as we have the necessary means, we will proceed with the registration and organization prior to the preliminary phase. CONCLUSIONS In this feasibility randomized clinical controlled trial, we will compare the effects of SWL blocking alone, administration of OM alone, and a combined intervention with both in patients with RP. We present this study so that it may be replicated and incorporated into future studies at other institutions, as well as applied to additional inherited retinal dystrophies. The goal of presenting this protocol is to aid recent efforts in reducing the impact of sleeping disorders and other psychological disorders on the quality of life in patients with RP and recovering their self-autonomy. In addition, the results of this study will represent a significant step toward developing a novel low-cost therapy for patients with RP and validating a novel therapeutic target. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/49196.
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Affiliation(s)
- Salvador Pastor-Idoate
- Institute of Applied Ophthalmobiology, University of Valladolid, Valladolid, Spain
- Department of Ophthalmology, Clinical University Hospital of Valladolid, Valladolid, Spain
- Networks of Cooperative Research oriented to Health Results, National Institute of Health Carlos III, Madrid, Spain
- European Reference Network dedicated to Rare Eye Diseases, Valladolid, Spain
| | - Milagros Mateos-Olivares
- Department of Ophthalmology, Clinical University Hospital of Valladolid, Valladolid, Spain
- Department of Ophthalmology, Clinical University Hospital of Caceres, Caceres, Spain
| | - Eva María Sobas
- Institute of Applied Ophthalmobiology, University of Valladolid, Valladolid, Spain
- Nursing School, University of Valladolid, Valladolid, Spain
| | - Miguel Marcos
- Department of Internal Medicine, University Hospital of Salamanca, Salamanca, Spain
- Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain
| | - Alfredo Toribio
- Federation of Associations of Hereditary Retinal Dystrophies in Spain, Valladolid, Spain
| | - José Carlos Pastor
- Institute of Applied Ophthalmobiology, University of Valladolid, Valladolid, Spain
- Networks of Cooperative Research oriented to Health Results, National Institute of Health Carlos III, Madrid, Spain
- European Reference Network dedicated to Rare Eye Diseases, Valladolid, Spain
| | - Ricardo Usategui Martín
- Institute of Applied Ophthalmobiology, University of Valladolid, Valladolid, Spain
- Department of Cellular Biology, Faculty of Medicine, University of Valladolid, Valladolid, Spain
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Markowska M, Niemczyk S, Romejko K. Melatonin Treatment in Kidney Diseases. Cells 2023; 12:cells12060838. [PMID: 36980179 PMCID: PMC10047594 DOI: 10.3390/cells12060838] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Melatonin is a neurohormone that is mainly secreted by the pineal gland. It coordinates the work of the superior biological clock and consequently affects many processes in the human body. Disorders of the waking and sleeping period result in nervous system imbalance and generate metabolic and endocrine derangements. The purpose of this review is to provide information regarding the potential benefits of melatonin use, particularly in kidney diseases. The impact on the cardiovascular system, diabetes, and homeostasis causes melatonin to be indirectly connected to kidney function and quality of life in people with chronic kidney disease. Moreover, there are numerous reports showing that melatonin plays a role as an antioxidant, free radical scavenger, and cytoprotective agent. This means that the supplementation of melatonin can be helpful in almost every type of kidney injury because inflammation, apoptosis, and oxidative stress occur, regardless of the mechanism. The administration of melatonin has a renoprotective effect and inhibits the progression of complications connected to renal failure. It is very important that exogenous melatonin supplementation is well tolerated and that the number of side effects caused by this type of treatment is low.
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Jarrott B, Head R, Pringle KG, Lumbers ER, Martin JH. "LONG COVID"-A hypothesis for understanding the biological basis and pharmacological treatment strategy. Pharmacol Res Perspect 2022; 10:e00911. [PMID: 35029046 PMCID: PMC8929332 DOI: 10.1002/prp2.911] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/07/2021] [Indexed: 12/11/2022] Open
Abstract
Infection of humans with SARS‐CoV‐2 virus causes a disease known colloquially as “COVID‐19” with symptoms ranging from asymptomatic to severe pneumonia. Initial pathology is due to the virus binding to the ACE‐2 protein on endothelial cells lining blood vessels and entering these cells in order to replicate. Viral replication causes oxidative stress due to elevated levels of reactive oxygen species. Many (~60%) of the infected people appear to have eliminated the virus from their body after 28 days and resume normal activity. However, a significant proportion (~40%) experience a variety of symptoms (loss of smell and/or taste, fatigue, cough, aching pain, “brain fog,” insomnia, shortness of breath, and tachycardia) after 12 weeks and are diagnosed with a syndrome named “LONG COVID.” Longitudinal clinical studies in a group of subjects who were infected with SARS‐CoV‐2 have been compared to a non‐infected matched group of subjects. A cohort of infected subjects can be identified by a battery of cytokine markers to have persistent, low level grade of inflammation and often self‐report two or more troubling symptoms. There is no drug that will relieve their symptoms effectively. It is hypothesized that drugs that activate the intracellular transcription factor, nuclear factor erythroid‐derived 2‐like 2 (NRF2) may increase the expression of enzymes to synthesize the intracellular antioxidant, glutathione that will quench free radicals causing oxidative stress. The hormone melatonin has been identified as an activator of NRF2 and a relatively safe chemical for most people to ingest chronically. Thus, it is an option for consideration of re‐purposing studies in “LONG COVID” subjects experiencing insomnia, depression, fatigue, and “brain fog” but not tachycardia. Appropriately designed clinical trials are required to evaluate melatonin.
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Affiliation(s)
- Bevyn Jarrott
- Florey Institute of Neuroscience & Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Richard Head
- University of South Australia, Adelaide, South Australia, Australia
| | - Kirsty G Pringle
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Eugenie R Lumbers
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jennifer H Martin
- Centre for Drug Repurposing and Medicines Research, Clinical Pharmacology, University of Newcastle, New Lambton, New South Wales, Australia
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Mazza MG, Palladini M, Poletti S, Benedetti F. Post-COVID-19 Depressive Symptoms: Epidemiology, Pathophysiology, and Pharmacological Treatment. CNS Drugs 2022; 36:681-702. [PMID: 35727534 PMCID: PMC9210800 DOI: 10.1007/s40263-022-00931-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 12/12/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic is still spreading worldwide over 2 years since its outbreak. The psychopathological implications in COVID-19 survivors such as depression, anxiety, and cognitive impairments are now recognized as primary symptoms of the "post-acute COVID-19 syndrome." Depressive psychopathology was reported in around 35% of patients at short, medium, and long-term follow-up after the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Post-COVID-19 depressive symptoms are known to increase fatigue and affect neurocognitive functioning, sleep, quality of life, and global functioning in COVID-19 survivors. The psychopathological mechanisms underlying post-COVID-19 depressive symptoms are mainly related to the inflammation triggered by the peripheral immune-inflammatory response to the viral infection and to the persistent psychological burden during and after infection. The large number of SARS-CoV-2-infected patients and the high prevalence of post-COVID-19 depressive symptoms may significantly increase the pool of people suffering from depressive disorders. Therefore, it is essential to screen, diagnose, treat, and monitor COVID-19 survivors' psychopathology to counteract the depression disease burden and related years of life lived with disability. This paper reviews the current literature in order to synthesize the available evidence regarding epidemiology, clinical features, neurobiological underpinning, and pharmacological treatment of post-COVID-19 depressive symptoms.
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Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d'Ancona 20, 20127, Milan, Italy. .,Vita-Salute San Raffaele University, Milan, Italy. .,PhD Program in Cognitive Neuroscience, Vita-Salute San Raffaele University, Milan, Italy.
| | - Mariagrazia Palladini
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d’Ancona 20, 20127 Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy ,grid.15496.3f0000 0001 0439 0892PhD Program in Cognitive Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Sara Poletti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d’Ancona 20, 20127 Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, San Raffaele Turro, Via Stamira d’Ancona 20, 20127 Milan, Italy ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy
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Markus RP, Sousa KS, da Silveira Cruz-Machado S, Fernandes PA, Ferreira ZS. Possible Role of Pineal and Extra-Pineal Melatonin in Surveillance, Immunity, and First-Line Defense. Int J Mol Sci 2021; 22:12143. [PMID: 34830026 PMCID: PMC8620487 DOI: 10.3390/ijms222212143] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/23/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Melatonin is a highly conserved molecule found in prokaryotes and eukaryotes that acts as the darkness hormone, translating environmental lighting to the whole body, and as a moderator of innate and acquired defense, migration, and cell proliferation processes. This review evaluates the importance of pineal activity in monitoring PAMPs and DAMPs and in mounting an inflammatory response or innate immune response. Activation of the immune-pineal axis, which coordinates the pro-and anti-inflammatory phases of an innate immune response, is described. PAMPs and DAMPs promote the immediate suppression of melatonin production by the pineal gland, which allows leukocyte migration. Monocyte-derived macrophages, important phagocytes of microbes, and cellular debris produce melatonin locally and thereby initiate the anti-inflammatory phase of the acute inflammatory response. The role of locally produced melatonin in organs that directly contact the external environment, such as the skin and the gastrointestinal and respiratory tracts, is also discussed. In this context, as resident macrophages are self-renewing cells, we explore evidence indicating that, besides avoiding overreaction of the immune system, extra-pineal melatonin has a fundamental role in the homeostasis of organs and tissues.
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Affiliation(s)
- Regina P. Markus
- Laboratory Chronopharmacology, Department Physiology, Institute Bioscience, University of São Paulo, São Paulo 05508-090, Brazil; (K.S.S.); (P.A.F.); (Z.S.F.)
| | - Kassiano S. Sousa
- Laboratory Chronopharmacology, Department Physiology, Institute Bioscience, University of São Paulo, São Paulo 05508-090, Brazil; (K.S.S.); (P.A.F.); (Z.S.F.)
| | - Sanseray da Silveira Cruz-Machado
- Laboratory of Molecular, Endocrine and Reproductive Pharmacology, Department of Pharmacology, Escola Paulista de Medicina, UNIFESP, São Paulo 04044-020, Brazil;
| | - Pedro A. Fernandes
- Laboratory Chronopharmacology, Department Physiology, Institute Bioscience, University of São Paulo, São Paulo 05508-090, Brazil; (K.S.S.); (P.A.F.); (Z.S.F.)
| | - Zulma S. Ferreira
- Laboratory Chronopharmacology, Department Physiology, Institute Bioscience, University of São Paulo, São Paulo 05508-090, Brazil; (K.S.S.); (P.A.F.); (Z.S.F.)
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Markus R. Letter to the Editor. Brain Struct Funct 2021; 227:5-6. [PMID: 34549328 DOI: 10.1007/s00429-021-02386-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Regina Markus
- Institute Bioscience, University of São Paulo, São Paulo, Brazil.
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Liu D, Shi K, Fu M, Chen F. Melatonin indirectly decreases gastric cancer cell proliferation and invasion via effects on cancer-associated fibroblasts. Life Sci 2021; 277:119497. [PMID: 33864820 DOI: 10.1016/j.lfs.2021.119497] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/13/2021] [Accepted: 04/03/2021] [Indexed: 02/07/2023]
Abstract
AIMS Gastric cancer is a malignant tumor with a poor prognosis, and the interaction between tumor cells and cancer-associated fibroblasts (CAFs) further contributes to progression and treatment failure. Recent studies have revealed the potential value of melatonin in cancer therapy, but its role in gastric cancer and CAFs requires further exploration. MAIN METHODS CAFs were isolated using the tissue block method. Cell Counting Kit-8 and cell cycle assays were used to determine the cell proliferation ability, while the cell metastatic capacity was detected by a wound healing assay and Transwell migration/invasion assay. Furthermore, the expression levels of proteins involved were examined using quantitative real-time PCR (qRT-PCR) and western blotting. KEY FINDINGS Melatonin not only inhibits cell proliferation and metastasis by reducing the production of reactive oxygen species (ROS) in gastric cancer cells but also inhibits CAFs-induced gastric cancer cell progression by reducing the production of metalloproteinase 2 (MMP2) and metalloproteinase 2 (MMP9) in CAFs. The direct and indirect inhibitory effects of melatonin on gastric cancer cells are involved in the NF-kB signaling pathways. SIGNIFICANCE This study provides insights into the role of melatonin in the tumor microenvironment, further deepens available knowledge regarding the mechanism of action of melatonin in gastric cancer and suggests the potential value of melatonin in gastric cancer treatment.
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Affiliation(s)
- Dongyang Liu
- Division of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China
| | - Ke Shi
- College of Fisheries and Life Science, Shanghai Ocean University, Shanghai 201306, PR China
| | - Mingshi Fu
- College of Fisheries and Life Science, Shanghai Ocean University, Shanghai 201306, PR China
| | - Feng Chen
- Division of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China.
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Jia X, Zhang L, Zhang W, Zhou Y, Song Y, Liu C, Yang N, Sun J, Sun Z, Li Z, Shi C, Han Y, Yuan Y, Shi J, Liu Y, Guo X. Melatonin ameliorates the sleep disorder induced by surgery under sevoflurane anaesthesia in aged mice. Basic Clin Pharmacol Toxicol 2021; 128:256-267. [PMID: 32975883 DOI: 10.1111/bcpt.13498] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/01/2020] [Accepted: 09/13/2020] [Indexed: 11/30/2022]
Abstract
Post-operative sleep disorders induce adverse effects on patients, especially the elderly, which may be associated with surgery and inhalational anaesthetics. Melatonin is a neuroendocrine regulator of the sleep-wake cycle. In this study, we analysed the alterations of post-operative sleep in aged melatonin-deficient (C57BL/6J) mice, and investigated if exogenous melatonin could facilitate entrainment of circadian rhythm after laparotomy under sevoflurane anaesthesia. The results showed that laparotomy under sevoflurane anaesthesia had a greater influence on post-operative sleep than sevoflurane alone. Laparotomy under anaesthesia led to circadian rhythm shifting forward, altered EEG power density and delta power of NREM sleep, and lengthened REM and NREM sleep latencies. In the light phase, the number of waking episodes tended to decline, and wake episode duration elevated. However, these indicators presented the opposite tendency during the dark phase. Melatonin showed significant efficacy for ameliorating the sleep disorder and restoring physiological sleep, and most of the beneficial effect of melatonin was antagonized by luzindole, a melatonin receptor antagonist.
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Affiliation(s)
- Xixi Jia
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Liqun Zhang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Wen Zhang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yang Zhou
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Yanan Song
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Chang Liu
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Ning Yang
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Jie Sun
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Zhuonan Sun
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Zhengqian Li
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Chengmei Shi
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Yongzheng Han
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Yi Yuan
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yajie Liu
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
| | - Xiangyang Guo
- Department of Anesthesiology, Peking University Third Hospital, Beijing, China
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Adikwu E, Ebinyo N. Potential Therapeutic Activities of Melatonin and Alpha Lipoic Acid on Methotrexate-Induced Hepatotoxicity in Rats. EGYPTIAN JOURNAL OF BASIC AND CLINICAL PHARMACOLOGY 2020. [DOI: 10.32527/2020/101433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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10
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Simko F, Baka T. Chronotherapy as a potential approach to hypertensive patients with elevated heart rate? Br J Clin Pharmacol 2019; 85:1861-1862. [PMID: 31222884 DOI: 10.1111/bcp.14020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/24/2019] [Accepted: 05/22/2019] [Indexed: 01/10/2023] Open
Affiliation(s)
- Fedor Simko
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,3rd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Tomas Baka
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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