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He L, Peng Y, Ding M. Analysis of the effectiveness and safety of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis: An observational study. Medicine (Baltimore) 2024; 103:e38582. [PMID: 38968509 PMCID: PMC11224804 DOI: 10.1097/md.0000000000038582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 05/23/2024] [Indexed: 07/07/2024] Open
Abstract
This study is for exploring the effectiveness and security of Jiedu Xiezhuo Yishen Tang in the treatment of gouty arthritis. This retrospective study collected 100 patients with gouty arthritis between February 2022 and February 2023. According to the different treatment methods, the data of patients were divided into control group and experimental group. The control group received routine treatment with benzbromarone, while the experimental group received additional treatment with Xuedu Xiezhuo Yishen Tang on the basis of the control group. The evaluation indicators for the effectiveness of treatment include serum levels of 8-hydroxydeoxyguanosine, 3-NT, interleukin-6, interleukin-10, interleukin-1β, tumor necrosis factor-α, C-reactive protein, erythrocyte sedimentation rate, urea nitrogen, creatinine, evaluation of knee joint function and pain level, traditional Chinese medicine syndrome score, and safety evaluation. After treatment, the overall treatment effect of the experimental group reached 98%, while the control group was 78%. After treatment, the differences in various indicators possessed statistical significance (SS) (P < .05). In the Lysholm score, the improvement in the experimental group was markedly more excellent than the control group, and the difference possessed SS (P < .05). In the NRS score, the experimental group's NRS score decreased from 8.39 to 1.08 before and after treatment, while the control group only decreased to 3.61. In addition, both groups of patients showed significant improvement in the joint score in the Traditional Chinese medicine syndrome sub-items. The experimental group was able to effectively improve symptoms such as joint pain, joint redness and swelling, joint fever, and limited joint mobility. After treatment, the incidence of adverse reactions in the experimental group was only 8%, while the incidence of adverse reactions in the control group was 24%. After statistical analysis of the incidence of adverse reactions during treatment among the participants, it was found that the difference possessed SS (P < .001). The combination treatment of Jiedu Xiezhuo Yishen Tang and benbromarone can effectively improve oxidative stress response and significantly reduce blood uric acid levels. Meanwhile, this combination therapy can effectively inhibit inflammatory reactions, significantly alleviate knee joint pain, and promote the recovery of knee joint function. This treatment regimen has lower toxic side effects and higher safety.
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Affiliation(s)
- Ling He
- Rehabilitation Department, Wuhan Fifth Hospital, Wuhan, Hubei, China
| | - Yan Peng
- Rehabilitation Department, Wuhan Fifth Hospital, Wuhan, Hubei, China
| | - Mingqiao Ding
- Rehabilitation Department, Wuhan Fifth Hospital, Wuhan, Hubei, China
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Qian Y, Shen Y. Si Miao San relieves hyperuricemia by regulating intestinal flora. Biomed Chromatogr 2024; 38:e5807. [PMID: 38118432 DOI: 10.1002/bmc.5807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/14/2023] [Accepted: 11/26/2023] [Indexed: 12/22/2023]
Abstract
This study seeks to investigate the therapeutic effects of Si Miao San (SMS) on hyperuricemia and its underlying mechanisms, particularly focusing on the role of intestinal flora. The key components of SMS were identified using high-performance liquid chromatography (HPLC). To establish a rat model of hyperuricemia, an intraperitoneal injection of potassium oxonate was performed, followed by oral administration of various concentrations of SMS. The study evaluated the status of hyperuricemia, renal pathology, xanthine oxidase (XO) activity, and intestinal flora. Utilizing HPLC, we identified five active components of SMS. Following SMS intervention, there was a significant reduction in serum levels of uric acid (UA), blood urea nitrogen, and creatinine, accompanied by an increase in urine UA levels in rats with hyperuricemia. Distinct pathological injuries were evident in the renal tissues of hyperuricemic rats, and these were partially alleviated following SMS intervention. Moreover, SMS exhibited a dose-dependent reduction in XO activity both in the serum and hepatic tissues. Notably, SMS contributed to an enhancement in the diversity of intestinal flora in hyperuricemic rats. The intervention of SMS resulted in a reduction in the abundance of certain bacterial species, including Parabacteroides johnsonii, Corynebacterium urealyticum, and Burkholderiales bacterium. This suggests that SMS may exert anti-hyperuricemia effects, potentially by modulating the composition of intestinal flora.
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Affiliation(s)
- Yue Qian
- Rehabilitation Center, Hangzhou Wuyunshan Hospital (Hangzhou Institute of Health Promotion), Hangzhou, Zhejiang Province, China
| | - Yan Shen
- Department of Nursing, Hangzhou Wuyunshan Hospital (Hangzhou Institute of Health Promotion), Hangzhou, Zhejiang Province, China
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Murphy E, Gillies K, Shiely F. How do trial teams plan for retention during the design stage of the trial? A scoping review. Trials 2023; 24:784. [PMID: 38049833 PMCID: PMC10694955 DOI: 10.1186/s13063-023-07775-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 11/03/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Retention to trials is important to ensure the results of the trial are valid and reliable. The SPIRIT guidelines (18b) require "plans to promote participant retention and complete follow-up, including list of any outcome data to be collected for participants who discontinue or deviate from intervention protocols" be included in trial protocols. It is unknown how often protocols report this retention information. The purpose of our scoping review is to establish if, and how, trial teams report plans for retention during the design stage of the trial. MATERIALS AND METHODS A scoping review with searches in key databases (PubMed, Scopus, EMBASE, CINAHL (EBSCO), and Web of Science from 2014 to 2019 inclusive) to identify randomised controlled trial protocols. We produced descriptive statistics on the characteristics of the trial protocols and also on those adhering to SPIRIT item 18b. A narrative synthesis of the retention strategies was also conducted. RESULTS Eight-hundred and twenty-four protocols met our inclusion criteria. RCTs (n = 722) and pilot and feasibility trial protocols (n = 102) reported using the SPIRIT guidelines during protocol development 35% and 34.3% of the time respectively. Of these protocols, only 9.5% and 11.4% respectively reported all aspects of SPIRIT item 18b "plans to promote participant retention and to complete follow-up, including list of any outcome data for participants who discontinue or deviate from intervention protocols". Of the RCT protocols, 36.8% included proactive "plans to promote participant retention" regardless of whether they reported using SPIRIT guidelines or not. Most protocols planned "combined strategies" (48.1%). Of these, the joint most commonly reported were "reminders and data collection location and method" and "reminders and monetary incentives". The most popular individual retention strategy was "reminders" (14.7%) followed by "monetary incentives- conditional" (10.2%). Of the pilot and feasibility protocols, 40.2% included proactive "plans to promote participant retention" with the use of "combined strategies" being most frequent (46.3%). The use of "monetary incentives - conditional" (22%) was the most popular individual reported retention strategy. CONCLUSION There is a lack of reporting of plans to promote participant retention in trial protocols. Proactive planning of retention strategies during the trial design stage is preferable to the reactive implementation of retention strategies. Prospective retention planning and clear communication in protocols may inform more suitable choice, costing and implementation of retention strategies and improve transparency in trial conduct.
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Affiliation(s)
- Ellen Murphy
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), Galway, Ireland.
- Trials Research and Methodologies Unit (TRAMS), Health Research Board Clinical Research Facility University College Cork, Cork, Ireland.
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Frances Shiely
- Health Research Board - Trials Methodology Research Network (HRB-TMRN), Galway, Ireland
- Trials Research and Methodologies Unit (TRAMS), Health Research Board Clinical Research Facility University College Cork, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
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4
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Lee MJ, Godakandaarachchi P, Collins S, Racz M, Sharp A, Fidler S, Fox J. Understanding participant perspectives around HIV-1 cure-related studies involving antiretroviral analytical treatment interruptions in the United Kingdom. J Virus Erad 2023; 9:100360. [PMID: 38188642 PMCID: PMC10770752 DOI: 10.1016/j.jve.2023.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Background To test efficacy, HIV cure-related trials often require a period of intensively monitored interruption of antiretroviral therapy (ART) (analytical treatment interruption or ATI). As individuals who started ART during primary HIV-1 infection (PHI) are often recruited, we have asked people already enrolled into an observational PHI study about their willingness and concerns around participating in cure-related studies involving ATIs. Methods People who were diagnosed with PHI and started ART, attending two London HIV clinics, provided informed consent to complete a digital survey in clinic between 21/07/21 to October 31, 2023. Questions comprised sociodemographics, motivations, concerns and practical considerations influencing willingness to participate in studies involving ATIs. Hierarchical clustering of responses was performed using the 'pheatmap' R statistical package and ranked from most to least concerned. Responses were cross-referenced with enrolment into an ATI study which recruited from this cohort. Results Of 352 eligible participants, 75 completed the survey. The majority were white, cisgender men who have sex with men, 34/75 (45 %) were born outside the UK. 29 (39 %) expressed interest in joining ATI studies. Participants who were interested or unsure in joining ATI studies were primarily motivated (53/65, 82 % very or moderately interested) by an altruistic desire to help scientific research. Across all participants, onward HIV transmission was the predominant concern (67/75, 89 % very or moderately concerned), and similar levels of concerns reported if the HIV-1 viral load threshold to restarting ART was increased from 500 to 50 000 copies/mL. Most participants preferred weekly (23/65, 35 %) or fortnightly (11/65, 17 %) viral load monitoring during an ATI. Before taking part in a study involving an ATI, participants stated they would prefer to discuss this with their HIV doctor (55/65, 85 %). Conclusion In this small survey, 39 % of respondents expressed interest in joining studies involving ATIs, primarily for altruistic reasons. Participants were more interested in joining a potential ATI study if a novel intervention was included than simply an ATI alone. The main concern expressed was risk of viral transmission. To inform practical and study design considerations for future ATI studies, unrestricted access for mitigation of transmission risk should be included, and regular, frequent viral load monitoring is preferred.
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Affiliation(s)
- Ming J. Lee
- Department of Infectious Disease, Imperial College London, UK
| | | | | | - Mariusz Racz
- Harrison Wing, Department of HIV, Guy's and St Thomas Hospital NHS Foundation Trust, UK
| | - Alice Sharp
- Harrison Wing, Department of HIV, Guy's and St Thomas Hospital NHS Foundation Trust, UK
| | - Sarah Fidler
- Department of Infectious Disease, Imperial College London, UK
| | - Julie Fox
- Harrison Wing, Department of HIV, Guy's and St Thomas Hospital NHS Foundation Trust, UK
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Xiong Z, An Q, Chen L, Xiang Y, Li L, Zheng Y. Cell or cell derivative-laden hydrogels for myocardial infarction therapy: from the perspective of cell types. J Mater Chem B 2023; 11:9867-9888. [PMID: 37751281 DOI: 10.1039/d3tb01411h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Myocardial infarction (MI) is a global cardiovascular disease with high mortality and morbidity. To treat acute MI, various therapeutic approaches have been developed, including cells, extracellular vesicles, and biomimetic nanoparticles. However, the clinical application of these therapies is limited due to low cell viability, inadequate targetability, and rapid elimination from cardiac sites. Injectable hydrogels, with their three-dimensional porous structure, can maintain the biomechanical stabilization of hearts and the transplantation activity of cells. However, they cannot regenerate cardiomyocytes or repair broken hearts. A better understanding of the collaborative relationship between hydrogel delivery systems and cell or cell-inspired therapy will facilitate advancing innovative therapeutic strategies against MI. Following that, from the perspective of cell types, MI progression and recent studies on using hydrogel to deliver cell or cell-derived preparations for MI treatment are discussed. Finally, current challenges and future prospects of cell or cell derivative-laden hydrogels for MI therapy are proposed.
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Affiliation(s)
- Ziqing Xiong
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qi An
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liqiang Chen
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.
| | - Yucheng Xiang
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.
| | - Lian Li
- Key Laboratory of Drug-Targeting and Drug Delivery System of the Education Ministry and Sichuan Province, Sichuan Engineering Laboratory for Plant-Sourced Drug and Sichuan Research Center for Drug Precision Industrial Technology, West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.
| | - Yaxian Zheng
- Department of Pharmacy, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, China
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Brockhoven F, Raphael M, Currier J, Jäderholm C, Mody P, Shannon J, Starling B, Turner-Uaandja H, Pashayan N, Arteaga I. REPRESENT recommendations: improving inclusion and trust in cancer early detection research. Br J Cancer 2023; 129:1195-1208. [PMID: 37689805 PMCID: PMC10575902 DOI: 10.1038/s41416-023-02414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
Abstract
Detecting cancer early is essential to improving cancer outcomes. Minoritized groups remain underrepresented in early detection cancer research, which means that findings and interventions are not generalisable across the population, thus exacerbating disparities in cancer outcomes. In light of these challenges, this paper sets out twelve recommendations to build relations of trust and include minoritized groups in ED cancer research. The Recommendations were formulated by a range of stakeholders at the 2022 REPRESENT consensus-building workshop and are based on empirical data, including a systematic literature review and two ethnographic case studies in the US and the UK. The recommendations focus on: Long-term relationships that build trust; Sharing available resources; Inclusive and accessible communication; Harnessing community expertise; Unique risks and benefits; Compensation and support; Representative samples; Demographic data; Post-research support; Sharing results; Research training; Diversifying research teams. For each recommendation, the paper outlines the rationale, specifications for how different stakeholders may implement it, and advice for best practices. Instead of isolated recruitment, public involvement and engagement activities, the recommendations here aim to advance mutually beneficial and trusting relationships between researchers and research participants embedded in ED cancer research institutions.
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Grants
- EICEDAAP\100011 Cancer Research UK
- Cancer Research UK (CRUK)
- The International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
- This work was supported by the International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
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Affiliation(s)
| | - Maya Raphael
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jessica Currier
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Christina Jäderholm
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - Perveez Mody
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jackilen Shannon
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Bella Starling
- Vocal, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Nora Pashayan
- Department of Applied Health Research, University College London, London, UK
| | - Ignacia Arteaga
- Department of Social Anthropology, University of Cambridge, Cambridge, UK.
- Early Cancer Institute, University of Cambridge, Cambridge, UK.
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Goulart Nacácio E Silva S, Occhiutto ML, Costa VP. The use of Nicotinamide and Nicotinamide riboside as an adjunct therapy in the treatment of glaucoma. Eur J Ophthalmol 2023; 33:1801-1815. [PMID: 36916064 DOI: 10.1177/11206721231161101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells (RGCs), which leads to progressive visual field loss and may result in blindness. Currently, the only available treatment to avoid or delay progression in glaucoma patients is to decrease intraocular pressure (IOP). However, despite adequate IOP control, approximately 25% of the patients continue to progress. To delay or prevent optic nerve damage in glaucoma, two forms of vitamin B3, nicotinamide (NAM) and nicotinamide riboside (NR) are emerging as viable adjuvant therapies. These compounds are nicotinamide adenine dinucleotide (NAD) precursors. NAD is essential for proper cell functioning and is involved in several metabolic activities, including protection against reactive oxygen species, contribution to the performance of various enzymes, and maintenance of mitochondrial function. Due to its beneficial effects and to the evidence of the reduction of NAD bioavailability with aging, researchers are seeking ways to replenish the cellular NAD pool, by administrating its precursors (NAM and NR), believing that it will reduce the RGC vulnerability to external stressors, such as increased IOP. This article attempts to analyze the current knowledge regarding the use of NAM and NR for the prevention and/or treatment of glaucoma.
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Xie EB, Freeman M, Penner-Goeke L, Reynolds K, Lebel C, Giesbrecht GF, Rioux C, MacKinnon A, Sauer-Zavala S, Roos LE, Tomfohr-Madsen L. Building Emotional Awareness and Mental Health (BEAM): an open-pilot and feasibility study of a digital mental health and parenting intervention for mothers of infants. Pilot Feasibility Stud 2023; 9:27. [PMID: 36800982 PMCID: PMC9938356 DOI: 10.1186/s40814-023-01245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND Maternal mental health concerns and parenting stress in the first few years following childbirth are common and pose significant risks to maternal and child well-being. The COVID-19 pandemic has led to increases in maternal depression and anxiety and has presented unique parenting stressors. Although early intervention is crucial, there are significant barriers to accessing care. METHODS To inform a larger randomized controlled trial, the current open-pilot trial investigated initial evidence for the feasibility, acceptability, and efficacy of a newly developed online group therapy and app-based mental health and parenting program (BEAM) for mothers of infants. Forty-six mothers 18 years or older with clinically elevated depression scores, with an infant aged 6-17 months old, and who lived in Manitoba or Alberta were enrolled in the 10-week program (starting in July 2021) and completed self-report surveys. RESULTS The majority of participants engaged in each of the program components at least once and participants indicated relatively high levels of app satisfaction, ease of use, and usefulness. However, there was a high level of attrition (46%). Paired-sample t-tests indicated significant pre- to post-intervention change in maternal depression, anxiety, and parenting stress, and in child internalizing, but not externalizing symptoms. Effect sizes were in the medium to high range, with the largest effect size observed for depressive symptoms (Cohen's d = .93). DISCUSSION This study shows moderate levels of feasibility and strong preliminary efficacy of the BEAM program. Limitations to program design and delivery are being addressed for testing in adequately powered follow-up trials of the BEAM program for mothers of infants. TRIAL REGISTRATION NCT04772677 . Registered on February 26 2021.
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Affiliation(s)
- E. Bailin Xie
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada
| | - Makayla Freeman
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
| | - Lara Penner-Goeke
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Kristin Reynolds
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada
| | - Catherine Lebel
- grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Radiology, University of Calgary, Calgary, AB Canada
| | - Gerald F. Giesbrecht
- grid.22072.350000 0004 1936 7697Department of Psychology, University of Calgary, Calgary, AB Canada ,grid.413571.50000 0001 0684 7358Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Charlie Rioux
- grid.266900.b0000 0004 0447 0018Department of Psychology, University of Oklahoma, Norman, OK USA
| | - Anna MacKinnon
- grid.14848.310000 0001 2292 3357Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC Canada ,grid.411418.90000 0001 2173 6322CHU Sainte-Justine Research Center, Montréal, QC Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Department of Psychology, University of Kentucky, Lexington, KY USA
| | - Leslie E. Roos
- grid.21613.370000 0004 1936 9609Department of Psychology, University of Manitoba, Winnipeg, MB Canada ,grid.460198.20000 0004 4685 0561Children’s Hospital Research Institute of Manitoba, Winnipeg, MB Canada
| | - Lianne Tomfohr-Madsen
- grid.17091.3e0000 0001 2288 9830Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC Canada
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Lewis AM. Modified Prolonged Exposure Therapy for Posttraumatic Stress Disorder with an 85-Year-Old Native American Cajun Man With Late-Onset Deafness: A Case Report. Clin Gerontol 2023:1-8. [PMID: 36732327 DOI: 10.1080/07317115.2023.2173693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Few studies of exposure therapy with adults 85 years and older exist. This case report presents results of prolonged exposure (PE) for posttraumatic stress disorder (PTSD) modified for an 85-year-old Native American Cajun man with late-onset deafness, who used a cochlear implant, and reported high Western/non-Native American acculturation. The following modifications were made primarily in response to the client's individual, disability-related barriers to completing the standard PE protocol: (a) inclusion of the client's spouse in aspects of treatment planning and homework assignments; (b) variable session length and frequency; (c) homework was limited to the daily practice of breathing retraining and in vivo exposure to triggering images; and (d) therapist reliance on nonverbal indicators of distress during imaginal exposures. METHODS The PTSD Checklist for DSM-5 (PCL-5) and 15-item Geriatric Depression Scale (GSD-15) were primary progress and outcome measures. RESULTS The modified treatment was associated with clinically significant decreases in baseline PTSD (19 points) and depressive (8 points) symptoms. CONCLUSIONS PE protocol modifications did not compromise treatment outcomes for this client. CLINICAL IMPLICATIONS PE protocols should be modified based on the individual needs of diverse older adults underrepresented in efficacy research.
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Affiliation(s)
- Adam M Lewis
- Alexandria VA Health Care System, Pineville, Louisiana
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A Brief Review of Natural Products with Urate Transporter 1 Inhibition for the Treatment of Hyperuricemia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5419890. [PMID: 36337587 PMCID: PMC9635963 DOI: 10.1155/2022/5419890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/15/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023]
Abstract
Hyperuricemia is a common disease caused by a high level of uric acid. Urate transporter 1 (URAT1) is an important protein and mediates approximately 90% of uric acid reabsorption. Therefore, the URAT1 inhibitor is a class of uricosuric medicines widely used in the clinic for the treatment of hyperuricemia. To find the new medicine with stronger URAT1 inhibition and lower toxicity, researchers have been exploring natural products. This study systematically summarizes the natural products with URAT1 inhibition. The results show that many natural products are potential URAT1 inhibitors, such as flavonoids, terpenoids, alkaloids, coumarins, stilbenes, and steroids, among which flavonoids are the most promising source of URAT1 inhibitors. It is worth noting that most studies have focused on finding natural products with inhibition of URAT1 and have not explored their activities and mechanisms toward URAT1. By reviewing the few existing studies of the structure-activity relationship and analyzing common features of natural products with URAT1 inhibition, we speculate that the rigid ring structure and negative charge may be the keys for natural products to produce URAT1 inhibition. In conclusion, natural products are potential URAT1 inhibitors, and exploring the mechanism of action and structure-activity relationship will be an important research direction in the future.
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