Hasil untuk "Medicine"

M. Murphy, Kathryn Moncivais, A. Caplan

Mesenchymal stem cells (MSCs) are partially defined by their ability to differentiate into tissues including bone, cartilage and adipose in vitro, but it is their trophic, paracrine and immunomodulatory functions that may have the greatest therapeutic impact in vivo. Unlike pharmaceutical treatments that deliver a single agent at a specific dose, MSCs are site regulated and secrete bioactive factors and signals at variable concentrations in response to local microenvironmental cues. Significant progress has been made in understanding the biochemical and metabolic mechanisms and feedback associated with MSC response. The anti-inflammatory and immunomodulatory capacity of MSC may be paramount in the restoration of localized or systemic conditions for normal healing and tissue regeneration. Allogeneic MSC treatments, categorized as a drug by regulatory agencies, have been widely pursued, but new studies demonstrate the efficacy of autologous MSC therapies, even for individuals affected by a disease state. Safety and regulatory concerns surrounding allogeneic cell preparations make autologous and minimally manipulated cell therapies an attractive option for many regenerative, anti-inflammatory and autoimmune applications.

Kurt J.isselbacher

Y. Tu

S. Straus

S. Grover, R. Grewal

M. Nelson, W. Rejeski, Steven N. Blair et al.

E. Giannoni

L. Goldman, J. Bennett

J. Rhule, C. Hill, D. Judd et al.

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D. Bhatnagar, M. Simon, M. Rafailovich

Regenerative medicine requires materials that are biodegradable, biocompatible, struc‐ turally and chemically stable, and that can mimic the properties of the native extracellular matrix (ECM). Hydrogels are hydrophilic three-dimensional networks that have long re‐ ceived attention in the field of regenerative medicine due to their unique properties. Hy‐ drogels have a potential to be the future of regenerative medicine due to their desirable mechanical and chemical properties, ease of their synthesis, and their multiple applicabil‐ ity as drug delivery vehicles, scaffolds, and constructs for cell culture. In this chapter, we have described hydrogels in terms of their cross-linking and then discussed the most re‐ cent developments in the use of hydrogels for peripheral nerve regeneration, tooth regen‐ eration, and 3D bioprinting.

S. Mura, P. Couvreur

S. Sen, R. Chakraborty

In spite of incredible advances in modern science, technology and allopathic medicine a large we are unable to provide quality healthcare to all. Traditional medicine particularly herbal medicine considered as a major healthcare provider around the globe particularly in rural and remote areas. A large section of people depends on such medicine for their primary healthcare mainly in underdeveloped or developing countries. Indian traditional medicinal system like Ayurveda, Siddha and Unani has a very rich history of their effectiveness; modern research also acknowledged the importance of such medicine. Indian traditional medicine or medicinal plants are also considered as a vital source of new drug. Mainstreaming of such medicine is important for the people. Several steps have been taken in India to promote such medicine and to integrate them into clinical practice. Evidence based incorporation of Indian traditional medicine in clinical practice will help to provide quality healthcare to all.

Robert Li, Z. Jia, M. Trush

M. Picard, D. Wallace, Y. Burelle

Once considered exclusively the cell's powerhouse, mitochondria are now recognized to perform multiple essential functions beyond energy production, impacting most areas of cell biology and medicine. Since the emergence of molecular biology and the discovery of pathogenic mitochondrial DNA defects in the 1980's, research advances have revealed a number of common human diseases which share an underlying pathogenesis involving mitochondrial dysfunction. Mitochondria undergo function-defining dynamic shape changes, communicate with each other, regulate gene expression within the nucleus, modulate synaptic transmission within the brain, release molecules that contribute to oncogenic transformation and trigger inflammatory responses systemically, and influence the regulation of complex physiological systems. Novel mitopathogenic mechanisms are thus being uncovered across a number of medical disciplines including genetics, oncology, neurology, immunology, and critical care medicine. Increasing knowledge of the bioenergetic aspects of human disease has provided new opportunities for diagnosis, therapy, prevention, and in connecting various domains of medicine. In this article, we overview specific aspects of mitochondrial biology that have contributed to - and likely will continue to enhance the progress of modern medicine.

L. Frese, Petra E. Dijkman, S. Hoerstrup

Zornitza Stark, T. Tan, B. Chong et al.

Purpose:Concerns about patient safety and the potential for medical error are largely unexplored for genetic testing, despite the expansion of test use. In this preliminary qualitative study, we sought the views of genetics professionals about error and patient safety concerns in genomic medicine and factors that might mitigate them.Methods:Twelve semistructured interviews with experienced genetics professionals were conducted. Transcripts were analyzed using selective coding for issues related to error definition, mitigation, and communication. Additional thematic analysis captured themes across content categories.Results:Key informants suggested that the potential for adverse events exists in all phases of genetic testing, from ordering to analysis, interpretation, and follow-up. A perceived contributor was lack of physician knowledge about genetics, resulting in errors in test ordering and interpretation. The limitations and uncertainty inherent to rapidly evolving technology were also seen as contributing factors. Strategies to prevent errors included physician education, availability of genetic experts for consultation, and enhanced communication such as improved test reports and electronic decision support.Conclusion:Genetic testing poses concerns for patient safety due to errors and the limitations of current tests. As genomic tests are integrated into medical care, anticipating and addressing patient safety concerns identified by these key informants will be crucial.Genet Med 18 11, 1136–1142.

Minghui Lu, Jiajun Wei, Qiang Cai

BackgroundThe optimal timing for tracheostomy in patients with intracerebral hemorrhage extending into the ventricles who require mechanical ventilation remains controversial, and there is a paucity of evidence to guide clinical practice. This study aimed to elucidate the impact of early vs. late tracheostomy on clinical outcomes and complications in this population, utilizing multivariable models to identify risk factors and define the potential beneficiary population.MethodsThis single-center retrospective cohort study consecutively enrolled 157 patients with severe spontaneous intracerebral hemorrhage extending into the ventricles requiring mechanical ventilation (GCS score ≤8) between January 2020 and December 2023. Based on the timing of tracheostomy, patients were classified into an early group (ET, ≤7 days after mechanical ventilation, n = 81) and a late group (LT, >7 days after mechanical ventilation, n = 76). Baseline characteristics, treatment measures, and outcome data were collected. Hematoma volumes in both the brain parenchyma and ventricles on admission CT scans were precisely quantified using 3D Slicer software. The primary outcome was the 6-month modified Rankin Scale (mRS) score. Secondary outcomes included the duration of mechanical ventilation, ICU length of stay (LOS), and the incidence of short-term complications [ventilator-associated pneumonia (VAP), new-onset arrhythmia, shock, and acute kidney injury (AKI)]. Multivariable logistic regression analysis was employed to identify independent risk factors for complications and to assess the protective effect of early tracheostomy.ResultsIn this cohort of 157 mechanically ventilated patients with severe intraventricular hemorrhage, baseline characteristics were well-balanced between Early (ET, n = 81) and Late Tracheostomy (LT, n = 76) groups. While 6-month functional outcomes (mRS) showed no significant difference (P = 0.360), the ET group demonstrated substantially shorter duration of mechanical ventilation (13 vs. 19 days, P < 0.001) and ICU stay (17 vs. 25 days, P < 0.001). ET was associated with significantly lower incidence of ventilator-associated pneumonia (28.40 vs. 48.68%, P = 0.009), new-onset arrhythmia (18.52 vs. 32.89%, P = 0.039), and shock requiring vasopressors (24.7 vs. 40.79%, P = 0.031). Multivariable analysis identified GCS score <6 (OR 3.588, P = 0.008) and Graeb score ≥8 (OR 8.735, P = 0.037) as independent risk factors for complications, while confirming early tracheostomy as an independent protective factor (aOR 0.306, P = 0.019) after adjustment for confounders.ConclusionIn this single-center retrospective cohort study, early tracheostomy was associated with shorter durations of mechanical ventilation and ICU stay, as well as a lower incidence of major complications, and demonstrates a favorable safety profile. Although it does not improve long-term neurological function, early tracheostomy serves as an independent protective factor. When combined with the identification of risk factors such as GCS <6 and Graeb score ≥8, it provides a basis for individualized treatment. These findings suggest an association that warrants further investigation in prospective studies.

Fidele Benimana, Christopher Kucha, Anupam Roy et al.

ABSTRACT The global demand for edible flowers has increased due to their diverse applications in food, nutraceuticals, and the medical field. However, issues of species identification, adulteration, contamination, and quality necessitate the use of advanced methods to authenticate product quality for edible flowers. Conventional methods are expensive, time‐consuming, and require highly skilled personnel and technical expertise. Spectroscopic methods, including Fourier transform infrared, near‐infrared, and Raman spectroscopy, are efficient, fast, and non‐destructive, providing rapid insight into the chemical structure and authenticity of edible flowers. This review systematically summarizes the recent advances in spectroscopic methods for authenticating edible flowers, including the detection of chemical changes and ensuring product integrity. The primary goal is to examine the applications of spectroscopic techniques for assessing quality changes in edible flowers during processing for food applications. Spectroscopic techniques, such as FT‐IR, NIR, and Raman spectroscopy, are rapid, accurate, and non‐destructive alternatives for authenticating the composition and quality of edible flowers. These methods enable the detection of bioactive compounds, differentiation of species, and identification of adulterants with minimal sample processing. Furthermore, chemometric models enhance data analysis, allowing for automated classification and real‐time quality monitoring of edible flowers.

Katharina Kaltseis, Sarah Maier, Karin Zebenholzer et al.

Abstract Background Triptans are highly effective acute treatments for migraine attacks, yet population-level data suggest persistent underuse. Updated real-world data on triptan use and overuse in Austria are lacking. Methods This nationwide, retrospective claims-based study analysed triptan use and overuse in Austria in 2023. Adults (≥ 18 years) with at least one dispensed triptan were identified. Triptan overuse was defined as the dispensing of ≥ 30 defined daily doses (DDDs) in at least one quarter, consistent with the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Data on demographics, preventive migraine therapies, antidepressant use, sick leave, and hospital admissions were assessed and compared with data from 2007 using identical methodology. Results Among 7.75 million insured adults, 63,729 individuals (0.82%) fulfilled the inclusion criteria and used triptans, representing a 46% increase since 2007. However, this corresponds to an estimated number of approximately 8% of individuals with migraine. Triptan overuse more than doubled compared with 2007 (12.5% vs. 5.9%) and was associated with older age, with the largest proportion of overusers being 51–65 years old. Overusers showed substantially higher use of preventive therapies, including anti-calcitonin-gene-related-peptide (CGRP) antibodies (21.8% vs. 9.7%), and antidepressants (24.8% vs. 19.9%) (all p < 0.001). Hospital admissions were slightly more frequent among overusers, whereas sick-leave days were less frequent in this group. Women were more likely than men to use triptans, anti-CGRP antibodies, and antidepressants. Conclusion Despite increased triptan use over the past 15 years, overall utilization in Austria remains low, while the percentage of patients with triptan overuse has more than doubled. Preventive migraine therapies remain infrequently prescribed. Higher rates of hospital admissions and concomitant antidepressant use may indicate a greater overall disease burden among triptan overusers. Graphical Abstract