Nevin Manimala

Turk J Pharm Sci. 2022 Jun 27;19(3):336-342. doi: 10.4274/tjps.galenos.2021.41514.

ABSTRACT

OBJECTIVES: Drugs that inhibit the reuptake of serotonin, norepinephrine, and/or dopamine are widely used for treating depressive disorders and have emerged as effective drugs for neuropathic pain. They have no substantial anti-nociceptive effects but are considered, with gabapentin/pregabalin, first-line drugs for neuropathic pain.

MATERIALS AND METHODS: In this study, three different antidepressant agents were used in different doses to investigate their anti-hyperalgesic effects in rat models of neuropathic pain using hot plate and tail flick methods. They have different mechanisms of action; vilazodone hydrochloride is a selective serotonin inhibitor and a 5-HT_1A partial agonist; talsupram hydrochloride is a selective noradrenaline inhibitor, and it has a high affinity for noradrenaline transporter (NET), whereas indatraline hydrochloride is a triple reuptake inhibitor that inhibits transporters for 5-HT (SERT), dopamine (DAT), and NET.

RESULTS: All the drugs used in the experiment were found to have an anti-hyperalgesic effect in both tests compared to the sham group. When anti-hyperalgesic effects of the three agents were compared to each other, it was found that talsupram hydrochloride was significantly more effective than the two other drugs in hot plate test. However, there was no statistically significant difference in the tail flick test. Indatraline hydrochloride was more effective than vilazodone hydrochloride at the same doses in the tail flick test.

CONCLUSION: Our data suggest that three drugs are effective analgesics in rat models of neuropathic pain and inhibition of noradrenaline reuptake represents the cornerstone of analgesic mechanisms of effective antidepressants.

PMID:35775407 | DOI:10.4274/tjps.galenos.2021.41514

Turk J Pharm Sci. 2022 Jun 27;19(3):330-335. doi: 10.4274/tjps.galenos.2021.14603.

ABSTRACT

OBJECTIVES: The concern for finding natural and curative agents without adverse side effects has prompted the interest in discovering hemostatic agents from plants. Therefore, in vitro activity of Aizoon hispanicum L. (Aizoaceae), Centaurea hyalolepis Boiss. (Asteraceae), Heliotropium maris-mortui Zohary. (Boraginaceae), Parietaria judaica L. (Urticaceae), Polygonum arenarium Waldst. & Kit. (Polygonaceae), and Verbascum sinuatum L. (Scrophulariaceae) on blood coagulation was estimated by two common tests, which are the prothrombin time test (PT) and the activated partial thromboplastin time test (aPTT).

MATERIALS AND METHODS: The extracted powders from the plants under this study were adjusted to be 50 mg/mL. Then, in vitro effect of these extracts on the platelet poor plasma samples was measured by an automated coagulation analyzer using PT and aPTT tests.

RESULTS: Based on the obtained results, all plant extracts affected the coagulation cascade by rising either PT or aPTT or both, except for V. sinuatum extract, which reduced only aPTT value. Moreover, the recorded PT values showed that A. hispanicum, H. maris-mortui, and P. arenarium significantly prolonged the PT (p<0.05). Additionally, the results clearly showed that V. sinuatum acted as a coagulant agent based on aPTT values, while all other plants, in contrast, acted as strong anticoagulants. Among the plant species under study, A. hispanicum, H. maris-mortui, and P. arenarium extracts prolonged both PT and aPTT significantly (p<0.05). This could be referred to their additional effect on the common pathway. However, C. hyalolepis, P. judaica, and V. sinuatum showed no significant effect on PT values (p>0.05).

CONCLUSION: The positive recorded data from this research could serve as identification of new hemostatic remedies that could be used for the commercial economic purposes and for managing several cardiovascular diseases.

PMID:35775406 | DOI:10.4274/tjps.galenos.2021.14603

Turk J Pharm Sci. 2022 Jun 27;19(3):305-313. doi: 10.4274/tjps.galenos.2021.94556.

ABSTRACT

OBJECTIVES: This study aimed to identify the prevalence of potentially inappropriate medication use (PIMU) in adults above the age of 65 with chronic kidney disease (CKD) according to the American Geriatric Society Beers Criteria (Beers), Screening Tool of Older People’s Potentially Inappropriate Prescriptions Criteria (STOPP) and medication appropriateness index (MAI) 30 criteria and to compare them to justify their use in this specific patient group.

MATERIALS AND METHODS: This was a retrospective and descriptive study conducted between October 1^st, 2019 and March 18^th, 2020 at Ibni Sina Hospital, Nephrology Department, Faculty of Medicine, Ankara University.

RESULTS: Among 269 patients discharged from the hospital during the study period, 100 of them were eligible for the study. The mean age was 73.3 ± 6.9 years and 51.9% of them were male. The prevalence of 35 PIMU was 91%, 42%, and 70% according to the Beers, STOPP, and MAI criteria, respectively. There was a statistically significant difference in terms of prevalence among 3 criteria (p<0.001). Beer detected more PIMU (11.3% vs. 6.4%) and had higher sensitivity among older adults with CKD (0.97 vs. 0.56) compared to the STOPP criteria. Most patients had at least one drug-drug interaction (DDIs) in their discharge prescription (93%) and DDI was one of the main contributors of PIMU. Proton pump inhibitors were the most common medication associated with PIMU in all 3 criteria.

CONCLUSION: The prevalence of PIMU was high among older adults with CKD at discharge according to these criteria. To improve the prescriptions after hospital discharge, it is considered appropriate to use Beers criteria under guidance of a clinical pharmacist.

PMID:35775387 | DOI:10.4274/tjps.galenos.2021.94556

Oncol Rep. 2022 Aug;48(2):147. doi: 10.3892/or.2022.8359. Epub 2022 Jul 1.

ABSTRACT

The clinical introduction of molecular imaging for the management of oropharyngeal squamous cell carcinoma (OPSCC) relies on the identification of relevant cancer‑specific biomarkers. The application of three membrane‑bound receptors, namely urokinase‑type plasminogen activator receptor (uPAR), tissue factor (TF) and EGFR have been previously explored for targeted imaging and therapeutic strategies in a broad range of solid cancers. The present study aimed to investigate the expression patterns of uPAR, EGFR and TF by immunohistochemistry (IHC) to evaluate their potential for targeted imaging and prognostic value in OPSCC. In a retrospective cohort of 93 patients with primary OPSCC, who were balanced into the 45 human papillomavirus (HPV)‑positive and 48 HPV‑negative groups, the IHC‑determined expression profiles of uPAR, TF and EGFR in large biopsy or tumor resection specimens were analyzed. Using the follow‑up data, overall survival (OS) and recurrence‑free survival were measured. Specifically, associations between survival outcome, biomarker expression and clinicopathological factors were examined using Cox proportional hazards model and log‑rank test following Kaplan‑Meier statistics. After comparing the expression pattern of biomarkers within the tumor compartment with that in the adjacent normal tissues, uPAR and TF exhibited a highly tumor‑specific expression pattern, whereas EGFR showed a homogeneous expression within the tumor compartment as well as a consistent expression in the normal mucosal epithelium and salivary gland tissues. The positive expression rate of uPAR, TF and EGFR in the tumors was 98.9, 76.3 and 98.9%, respectively. No statistically significant association between biomarker expression and survival outcome could be detected. Higher uPAR expression levels had a trend towards reduced OS according to results from univariate analysis (P=0.07; hazard ratio=2.01; 95% CI=0.92‑4.37). Taken together, these results suggest that uPAR, TF and EGFR may be suitable targets for molecular imaging and therapy in OPSCC. In particular, uPAR may be an attractive target owing to their high positive expression rates in tumors and a highly tumor‑specific expression pattern.

PMID:35775375 | DOI:10.3892/or.2022.8359

Psychol Med. 2022 Jul 1:1-10. doi: 10.1017/S003329172200191X. Online ahead of print.

ABSTRACT

BACKGROUND: Posttraumatic stress symptoms (PTSS) are common following traumatic stress exposure (TSE). Identification of individuals with PTSS risk in the early aftermath of TSE is important to enable targeted administration of preventive interventions. In this study, we used baseline survey data from two prospective cohort studies to identify the most influential predictors of substantial PTSS.

METHODS: Self-identifying black and white American women and men (n = 1546) presenting to one of 16 emergency departments (EDs) within 24 h of motor vehicle collision (MVC) TSE were enrolled. Individuals with substantial PTSS (⩾33, Impact of Events Scale – Revised) 6 months after MVC were identified via follow-up questionnaire. Sociodemographic, pain, general health, event, and psychological/cognitive characteristics were collected in the ED and used in prediction modeling. Ensemble learning methods and Monte Carlo cross-validation were used for feature selection and to determine prediction accuracy. External validation was performed on a hold-out sample (30% of total sample).

RESULTS: Twenty-five percent (n = 394) of individuals reported PTSS 6 months following MVC. Regularized linear regression was the top performing learning method. The top 30 factors together showed good reliability in predicting PTSS in the external sample (Area under the curve = 0.79 ± 0.002). Top predictors included acute pain severity, recovery expectations, socioeconomic status, self-reported race, and psychological symptoms.

CONCLUSIONS: These analyses add to a growing literature indicating that influential predictors of PTSS can be identified and risk for future PTSS estimated from characteristics easily available/assessable at the time of ED presentation following TSE.

PMID:35775366 | DOI:10.1017/S003329172200191X

J Clin Ultrasound. 2022 Jul 1. doi: 10.1002/jcu.23263. Online ahead of print.

ABSTRACT

BACKGROUND: During the Coronavirus Disease 2019 (COVID-19) pandemic, patients present to hospitals with a wide range of symptoms. Some of these symptoms include acute orchitis and epididymitis. The goal of this research is to see if COVID-19 infection and scrotal infection are associated.

MATERIALS AND METHODS: Patients with a COVID-19 (+) who agreed to a scrotal ultrasound (US) examination were studied prospectively in a tertiary care center between October 2021 and February 2022. The severity of the disease was used to divide patients into groups. Patients diagnosed with acute scrotal infection based on scrotal ultrasonography findings were compared in these groups, as were their age, comorbidities, and laboratory data.

RESULTS: The median age of the 213 participants was 61.7 ± 8.3. During the ultrasonographic examination of the patients, 15 (7%), 8 (3.7%), 17 (7.9%), and 40 (18.7%) were diagnosed with acute orchitis, acute epididymitis, acute epididymo-orchitis, and scrotal infection, respectively. Acute scrotal infection was far more common in patients with a higher clinical severity of the disease. The patients’ comorbidities were also assessed, and it was discovered that they were statistically more common in the same group.

CONCLUSIONS: Even if there are no clinical symptoms, ultrasonography can help detect acute scrotal infection in COVID-19 patients. Furthermore, in groups with higher clinical severity, this association is more likely to be seen. It is critical to understand this in order to avoid complications.

PMID:35775362 | DOI:10.1002/jcu.23263

Arch Ital Urol Androl. 2022 Jun 30;94(2):252-263. doi: 10.4081/aiua.2022.2.252.

ABSTRACT

BACKGROUND: Alpha-adrenoreceptor antagonists or alpha-blockers are used in the treatment of hypertension, in the therapy of benign prostatic hyperplasia and in medical expulsive treatment of ureteral stones. These agents may affect the sexual function, with differences between drugs within the same class, depending on their selectivity for receptor subtypes. The aim of this review was to analyze the effects of alpha-blockers on sexual function.

MATERIALS AND METHODS: We conducted a systematic review and meta-analysis by searching PubMed, EMBASE and other databases for randomized controlled trials (RCTs) reporting sexual adverse effects in patients treated with alpha-blockers. Odds ratios for sexual dysfunction were calculated using random effects Mantel-Haenszel statistics.

RESULTS: Out of 608 records retrieved, 75 eligible RCTs were included in the meta-analysis. Compared with placebo, alphablockers were associated with increased odds of ejaculatory disorders both in patients with lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia (BPH) (OR: 7.53, 95% CI: 3.77-15.02, Z = 5.73, p < 0.00001, I2 = 55%) and in patients with ureteral stones (OR: 2.88, 95% CI: 1.50-5.44, Z = 3.19, p < 0.001, I2 = 31%). Uroselective alpha-blockers showed higher odds of ejaculatory disorders. Conversely, nonselective alpha-blockers were not associated with higher odds of ejaculatory dysfunction. Silodosin was associated with increased odds of ejaculatory dysfunction compared with tamsulosin (OR: 3.52, 95% CI: 2.18-5.68, 15 series, 1512 participants, Z = 5.15, p < 0.00001, I2 = 0%). Naftopidil and alfuzosin showed lower odds of ejaculatory dysfunction compared to uroselective alpha-blockers.No statistically significant differences in the odds of erectile dysfunction were observed when alpha-blockers were compared to placebo.

PMID:35775356 | DOI:10.4081/aiua.2022.2.252

Arch Ital Urol Androl. 2022 Jun 30;94(2):217-221. doi: 10.4081/aiua.2022.2.217.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the predictive value of platelet volume indices (PVIs), such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), as prognostic parameters of detumescence in acute ischemic priapism (IP) patients with sickle cell anemia (SCA) in steady-state who received intracavernosal injections of phenylephrine with aspiration and saline irrigation.

METHODS: Fifty-six SCA patients with acute IP and 54 healthy male control subjects were included in the research. Priapism was diagnosed by penile Doppler ultrasound and corporal blood gas tests before intervention. Measurements of PVIs (MPV, PDW, and PCT) and TLC were ordered for all participants. Additionally, the duration of priapism was recorded. The area under the curves was calculated by receiver operating characteristic (ROC) regression analysis.

RESULTS: The detumescence rate was 71.4% after the intervention. Compared to the control group, priapic SCA patients showed significantly higher PLT (p = 0.011), MPV (p = 0.002), PDW (p = 0.032), PCT values (p = 0.022), and TLC (p = 0.027). Higher MPV, PDW, and PCT values were observed in unsuccessful detumescence patients compared to the resolution group (p < 0.05). Statistically significant cutoff values for persistent priapism were measured by ROC as PLT: ⩾ 254×103/μL; MPV: ⩾ 13.2 fL; PDW: ⩾ 15.6 fL; PCT: ⩾ 24%; and TLC ≥ 8.5×103/L. Priapism duration of ≤ 17.9 hours was significantly related to detumescence rate (p = 0.000). Multivariable logistic regression analysis showed that priapism duration and higher MPV are prognostic parameters for detumescence in SCA.

CONCLUSIONS: The higher MPV and duration of priapism can be used as parameters for evaluating detumescence outcomes in steady-state SCA with acute IP.

PMID:35775350 | DOI:10.4081/aiua.2022.2.217

Arch Ital Urol Androl. 2022 Jun 30;94(2):206-210. doi: 10.4081/aiua.2022.2.206.

ABSTRACT

BACKGROUND: In the tubularized incised plate (TIP) procedure, flap interposition between the skin and neourethra is highly recommended to decrease the postoperative fistula rate. However, there is no consensus regarding the ideal flap for this procedure. This study aimed to report our experiences in the one-stage TIP hypospadias surgery utilizing dartos flap (DF) (penile skin subcutaneous tissue) and tunica vaginalis flap (TVF) (parietal layer of the testis) as a tissue coverage of neourethra.

METHODS: In a retrospective study from Sep 2018 to May 2021, 16 cases of hypospadias with different types, ranging from midpenile to penoscrotal types, were managed with TIP urethroplasty using DF or TVF as a tissue coverage of neourethra were enrolled. The demographic characteristics of the participants, type of hypospadias, outcome, and complications were analyzed and compared.

RESULTS: We used TVF and DF as soft tissue coverage in 11 (68.8%) and 5 (31.3%) patients, respectively. The mean age was 56.38 ± 47.83 months. Mid-penile, proximal, and penoscrotal hypospadias were presented in 3 (18.8%), 8 (50.0%), and 5(31.2%) patients, respectively. The total success rate was 14 (87.5%), while 2 (12.5%) patients developed a urethrocutaneous fistula, which required delayed closure later. In comparison between TVF and DF groups: the TVF was applied in all patients with moderate and severe chordee and all patients with penoscrotal hypospadias, and six patients with proximal hypospadias, while only three patients with mild chordee and two patients with proximal hypospadias used the DF and showed statistical significance between groups (p < 0.001 and 0.012) respectively. The success rate was 90.9% vs. 80.0% in TVF and DF groups, respectively, with no statistical significance between groups (p = 1.000).

CONCLUSIONS: In the primary TIP repair, the TVF is a practical option as a DF for the interposition cover of a neourethra, especially in penoscrotal and proximal hypospadias with severe chordee.

PMID:35775348 | DOI:10.4081/aiua.2022.2.206

Arch Ital Urol Androl. 2022 Jun 30;94(2):199-205. doi: 10.4081/aiua.2022.2.199.

ABSTRACT

OBJECTIVE: Chronic genitourinary infections can alter male fertility and even promote carcinogenic processes. This study aimed to evaluate the effect of the presence in the semen of microorganisms on semen quality.

MATERIALS AND METHODS: Clinical symptoms and conventional and functional seminal parameters of eleven fertile donors and ten volunteers with prostatitis-like symptoms were evaluated. Nitric oxide, antioxidant capacity, and pro-inflammatory cytokines in semen and seminal plasma samples were also quantified. Finally, the expression of the ROR-γT, FoxP3, and T-bet genes in semen and the presence of DNA of microorganisms associated with prostatitis in urine and semen were evaluated.

RESULTS: When compared with fertile donors, volunteers with chronic prostatitis-like symptoms reported erectile dysfunction (0% vs. 10%, p = 0.2825) and premature ejaculation (0% vs. 40%; p = 0.0190). No statistically significant differences were observed in seminal parameters, cytokine measurement, antioxidant capacity, nitric oxide concentration and ROR-γT, FoxP3, T-bet. Microorganisms responsible for sexually transmitted infections and some bacteria associated with the microbiota and infections in the prostate gland were detected. In the semen from the subjects with prostatitis-like symptoms T. vaginalis DNA was detected; in addition, N. gonorrhoeae DNA was also detected in semen and urine samples. S. pyogenes was detected in the urine samples from the control group.

CONCLUSIONS: Prostatitis-like symptoms are a common finding in young men that affect sexual and reproductive health, but not always the seminal parameters or fertility. The presence of prostatitis- like symptoms does not affect seminal quality. However, it appears to be associated with an increased likelihood of erectile dysfunction and premature ejaculation. Thus, affecting the quality of life and sexual and reproductive health.

PMID:35775344 | DOI:10.4081/aiua.2022.2.199