Medicines

5 pages, 257 KiB

Open AccessEditorial

Ethics in Medicines: Exposing Unethical Practices and Corruption in All Sectors of Medicines Is Essential for Improving Global Public Health and Saving Patients’ Lives

by George J. Kontoghiorghes

Medicines 2021, 8(9), 54; https://doi.org/10.3390/medicines8090054 - 14 Sep 2021

Cited by 3 | Viewed by 3084

Abstract

While great strides have been made in science and medicine ensuring better living standards and health care for most human beings, many issues still remain, which are responsible for an increase in mortality and morbidity rates of millions of people worldwide, despite that [...] Read more.

While great strides have been made in science and medicine ensuring better living standards and health care for most human beings, many issues still remain, which are responsible for an increase in mortality and morbidity rates of millions of people worldwide, despite that in most cases the causes are preventable [...] Full article

(This article belongs to the Special Issue Medicines: Identifying, Exposing and Tackling Unethical and Corrupt Practices is Essential for Safeguarding Patient and Public Health Interests Worldwide)

7 pages, 1372 KiB

Open AccessCase Report

Advances in the Treatment of Gastrointestinal Bleeding: Safety and Efficiency of Transnasal Endoscopy

by Hiroyuki Abe, Kenya Kamimura, Yoshihisa Arao, Junji Kohisa and Shuji Terai

Medicines 2021, 8(9), 53; https://doi.org/10.3390/medicines8090053 - 14 Sep 2021

Cited by 1 | Viewed by 4077

Abstract

Acute upper gastrointestinal bleeding (UGIB) is a common disorder and a gastroenterological emergency. With the development of new techniques and devices, the survivability after gastrointestinal bleeding is improving. However, at the same time, we are facing the difficulty of severely complicated cases with [...] Read more.

Acute upper gastrointestinal bleeding (UGIB) is a common disorder and a gastroenterological emergency. With the development of new techniques and devices, the survivability after gastrointestinal bleeding is improving. However, at the same time, we are facing the difficulty of severely complicated cases with various diseases. For example, while endoscopic examination with a normal diameter endoscope is essential for the diagnosis and treatment of UGIB, there are several cases in which it cannot be used. In these cases, transnasal endoscopy (TNE) may be a viable treatment option. This report reviews current hemostatic devices for endoscopic treatment and the safety and efficiency of using TNE in complicated cases. The latter will be demonstrated in a case report where TNE was employed in a patient with severe esophageal stenosis. This review summarizes the advances made in the devices used and will provide further ideas for the physician in terms of combining these devices and TNE. Full article

(This article belongs to the Special Issue Perspective of Metabolism: Potential Therapeutic Targets of Metabolic Diseases such as Obesity-Associated Diabetes, Atherosclerosis and Fatty Liver)

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11 pages, 496 KiB

Open AccessBrief Report

Validation of the Zulfiqar Frailty Scale (ZFS): A New Tool for General Practitioners

by Abrar-Ahmad Zulfiqar

Medicines 2021, 8(9), 52; https://doi.org/10.3390/medicines8090052 - 04 Sep 2021

Cited by 4 | Viewed by 2580

Abstract

Introduction: The early detection of frailty, a frequent transient state that can be reversible in the elderly and is responsible for significant morbidity and mortality, helps prevent complications from it. Objective: To evaluate the performance of the “ZFS” tool to screen for frailty [...] Read more.

Introduction: The early detection of frailty, a frequent transient state that can be reversible in the elderly and is responsible for significant morbidity and mortality, helps prevent complications from it. Objective: To evaluate the performance of the “ZFS” tool to screen for frailty as defined SEGA scale criteria in an ambulatory population of patients at least 65 years of age. Methods: A prospective non-interventional study conducted in Alsace for a duration of six months that included patients aged 65 and over, judged to be autonomous with an ADL > 4/6. Results: In this ambulatory population of 102 patients with an average age of 76 years, frailty, according to modified SEGA criteria grid A, had a prevalence of 19.6%. Frailty, according to the “ZFS” tool, had a prevalence of 35.0%, and all of its elements except weight loss were significantly associated with frailty. Its threshold for identifying frailty is three criteria out of six. It was rapid (average completion time: 87 s), had a sensitivity of 100%, and a negative predictive value of 100%. Conclusions: The “ZFS” tool makes it possible to screen for frailty with a high level of sensitivity and a negative predictive value. Full article

(This article belongs to the Special Issue Frailty Syndrome in the Elderly: A Real Challenge for Our Society)

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8 pages, 582 KiB

Open AccessBrief Report

Frailty in Primary Care: Validation of the simplified Zulfiqar Frailty Scale (sZFS)

by Abrar-Ahmad Zulfiqar

Medicines 2021, 8(9), 51; https://doi.org/10.3390/medicines8090051 - 03 Sep 2021

Cited by 3 | Viewed by 2118

Abstract

Introduction: Frailty scales are used very rarely by general practitioners as they are time consuming and are not well-adapted to current needs. Thus, we have designed with general practitioners a new scale for the early and rapid detection of frailty syndrome, called the [...] Read more.

Introduction: Frailty scales are used very rarely by general practitioners as they are time consuming and are not well-adapted to current needs. Thus, we have designed with general practitioners a new scale for the early and rapid detection of frailty syndrome, called the simplified Zulfiqar Frailty Scale (sZFS). Patients and methods: This scale was tested in two general medicine practices in Normandy (France) for a total of six months and compared to the GFST tool “The Gerontopole Frailty Screening Tool”. Only patients who were over 65 years old with an ADL ≥ 4/6 were included. Results: 107 were patients included in the general medicine practice, with an average age of 74 years. The sZFS questionnaire has a shorter administration time than the GFST questionnaire (p < 0.001). Its sensitivity is of 93%, and its specificity is 58%. Its positive predictive value is 57%, and its negative predictive value is 93%. The area under the curve of the sZFS scale is 0.83 [0.76; 0.91] (IC95%). Conclusion: Our frailty screening scale is simple, relevant, and quick. Full article

(This article belongs to the Special Issue Early Diagnosis and Public Health and Ethics Issues)

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8 pages, 1850 KiB

Open AccessArticle

Incidence of Screw Loosening in Cortical Bone Trajectory Fixation Technique between Single- and Dual-Threaded Screws

by Chao-Hsuan Chen, Chih-Hsiu Tu, Der-Cherng Chen, Hsiang-Ming Huang, Hao-Yu Chuang, Der-Yang Cho, Da-Tian Bau and Han-Chung Lee

Medicines 2021, 8(9), 50; https://doi.org/10.3390/medicines8090050 - 02 Sep 2021

Cited by 1 | Viewed by 2710

Abstract

Purpose: This study aims to elucidate the radiological outcome after Cortical bone trajectory (CBT) screw fixation and whether dual-threaded (DT) screws should be used in the fusion surgery. Methods: 159 patients with degenerative lumbar disorder who had undergone midline lumbar inter-body fusion surgery [...] Read more.

Purpose: This study aims to elucidate the radiological outcome after Cortical bone trajectory (CBT) screw fixation and whether dual-threaded (DT) screws should be used in the fusion surgery. Methods: 159 patients with degenerative lumbar disorder who had undergone midline lumbar inter-body fusion surgery by CBT screw-fixation technique (2014 to 2018). Patient subgroups were based on single-threaded (ST) or DT screw, fixation length, as well as whether fixation involved to sacrum level (S1). Serial dynamic plain films were reviewed and an appearance of a halo phenomenon between screw–bone interfaces was identified as a case of screw loosening. Results: 29 patients (39.7%) in ST group and 10 patients (11.6%) in DT group demonstrated a halo phenomenon (p < 0.0001 ****). After subgrouping with fixation length, the incidence rates of a halo phenomenon in each group were 11.1%:3% (ST-1L vs. DT-1L), 37%:13.8% (ST-2L vs. DT-2L), and 84.2%:23.5% (ST-3L vs. DT-3L). Among the 85 patients with a fixation involved in S1, 26 patients (52%) with single-threaded screw (STS group) and 8 patients (22.8%) with dual-threaded screw (DTS group) demonstrated a halo appearance (p = 0.0078 **). After subgrouping the fixation level, the incidence of a halo appearance in each group was 25%:0% (STS-1L vs. DTS-1L), 40.9%:26.3% (STS-2L vs. DTS-2L), and 87.5%: 30% (STS-3L vs. DTS-3L). Conclusion: Both fixation length and whether fixation involved to S1 contribute to the incidence of screw loosening, the data supports clinical evidence that DT screws had greater fixation strength with an increased fixative stability and lower incidence of screw loosening in CBT screw fixation compared with ST screws. Level of evidence: 2. Full article

(This article belongs to the Special Issue PROTAC—From Bench to Bed)

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4 pages, 640 KiB

Open AccessOpinion

Coronavirus Disease 2019 (COVID-19) Crisis Measures: Health Protective Properties?

by Abdelaziz Ghanemi, Mayumi Yoshioka and Jonny St-Amand

Medicines 2021, 8(9), 49; https://doi.org/10.3390/medicines8090049 - 02 Sep 2021

Cited by 3 | Viewed by 2870

Abstract

The ongoing 2019 coronavirus disease (COVID-19) crisis has led governments to impose measures including mask wearing, physical distancing, and increased hygiene and disinfection, combined with home confinement and economic shutdown. Such measures have heavy negative consequences both on public health and the economy. [...] Read more.

The ongoing 2019 coronavirus disease (COVID-19) crisis has led governments to impose measures including mask wearing, physical distancing, and increased hygiene and disinfection, combined with home confinement and economic shutdown. Such measures have heavy negative consequences both on public health and the economy. However, these same measures have positive outcomes as “side effects” that are worth mentioning since they contribute to the improvement of some aspects of the population health. For instance, mask wearing helps to reduce allergies as well as the transmission of other airborne disease-causing pathogens. Physical distancing and social contact limitation help limit the spread of communicable diseases, and economic shutdown can reduce pollution and the health problems related to it. Decision makers could get inspired by these positive “side effects” to tackle and prevent diseases like allergies, infectious diseases and noncommunicable diseases, and improve health care and pathology management. Indeed, the effectiveness of such measures in tackling certain health problems encourages inspiration from COVID-19 measures towards managing selected health problems. However, with the massive damage COVID-19-related measures have caused to countries’ economies and people’s lives, the question of how to balance the advantages and disadvantages of these measures in order to further optimize them needs to be debated among health care professionals and decision makers. Full article

(This article belongs to the Special Issue COVID-19-Associated Diseases: The Uncertainty of Diagnosis and Treatment)

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16 pages, 1006 KiB

Open AccessArticle

Prospective Comparison of 24-Hour Urine Creatinine Clearance with Estimated Glomerular Filtration Rates in Chronic Renal Disease Patients of African Descent

by Marlene Tapper, Donovan A. McGrowder, Lowell Dilworth and Adedamola Soyibo

Medicines 2021, 8(9), 48; https://doi.org/10.3390/medicines8090048 - 01 Sep 2021

Viewed by 3200

Abstract

Background: The 24-hour (24-h) creatinine clearance (CrCl) is the most common method for measuring GFR in clinical laboratories. However, the limitations of CrCl have resulted in the widespread acceptance of mathematically derived estimated glomerular filtration rate (eGFR) using Cockcroft-Gault (CG), Modification of Diet [...] Read more.

Background: The 24-hour (24-h) creatinine clearance (CrCl) is the most common method for measuring GFR in clinical laboratories. However, the limitations of CrCl have resulted in the widespread acceptance of mathematically derived estimated glomerular filtration rate (eGFR) using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in predicting eGFR. The aim of the study was to compare 24-h CrCl with eGFR derived from these formulae and to identify which could be the best alternative. Method: A prospective study was conducted involving 140 CKD patients. Creatinine and cystatin C concentrations were determined using the cobas 6000 analyzer. The eGFR was calculated using the CG formula, 4-variable MDRD and CKD-EPI equations, and Bland-Alman plots bias was determined. Results: The CG and MDRD formulas had mean eGFR values similar to CrCl and correlation coefficients (r) were highest for CG (0.906) and lowest for MDRD (0.799). The CG equation was in agreement with 24-h CrCl in all but stage V CKD while the MDRD equation compared well in all except Stage IV CKD. The CG equation was positively biased (0.9857) while the MDRD had a negative bias (−0.05). Conclusion: The Cockcroft-Gault formula provides a more accurate assessment of GFR than 24-h CrCl and would be recommended as a substitute to provide the best estimate of GFR in our population. Full article

(This article belongs to the Special Issue Early Diagnosis and Public Health and Ethics Issues)

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12 pages, 1474 KiB

Open AccessArticle

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

by Abhijit Rathi, Swati B. Jadhav and Neha Shah

Medicines 2021, 8(9), 47; https://doi.org/10.3390/medicines8090047 - 30 Aug 2021

Cited by 25 | Viewed by 17219

Abstract

Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) [...] Read more.

Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) in patients suffering from COVID-19 induced fatigue. A randomized, multicentric, double blind, placebo-controlled trial was conducted in 200 patients with a complaint of post-COVID fatigue. The test arm (n = 100) received the oral supplements for 14 days and the control arm (n = 100) received a placebo. Treatment efficacy was compared using the Chalder Fatigue scale (CFQ-11), at various time points from days 1 to 14. The supplemental treatment resulted in resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. Subjects in the test arm showed a significantly greater reduction in total as well as physical and mental fatigue scores at all time points vs. the control arm. The supplements were well tolerated with no adverse events reported. This study demonstrates that a 14 days supplementation of ImmunoSEB + ProbioSEB CSC3 resolves post-COVID-19 fatigue and can improve patients’ functional status and quality of life. Full article

(This article belongs to the Special Issue COVID-19-Associated Diseases: The Uncertainty of Diagnosis and Treatment)

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12 pages, 425 KiB

Open AccessReview

The Effective Strategies to Avoid Medication Errors and Improving Reporting Systems

by Abbas Al Mutair, Saad Alhumaid, Abbas Shamsan, Abdul Rehman Zia Zaidi, Mohammed Al Mohaini, Alya Al Mutairi, Ali A. Rabaan, Mansour Awad and Awad Al-Omari

Medicines 2021, 8(9), 46; https://doi.org/10.3390/medicines8090046 - 27 Aug 2021

Cited by 14 | Viewed by 15793

Abstract

Background: Population-based studies from several countries have constantly shown excessively high rates of medication errors and avoidable deaths. An efficient medication error reporting system is the backbone of reliable practice and a measure of progress towards achieving safety. Improvement efforts and system changes [...] Read more.

Background: Population-based studies from several countries have constantly shown excessively high rates of medication errors and avoidable deaths. An efficient medication error reporting system is the backbone of reliable practice and a measure of progress towards achieving safety. Improvement efforts and system changes of medication error reporting systems should be targeted towards reductions in the likelihood of injury to future patients. However, the aim of this review is to provide a summary of medication errors reporting culture, incidence reporting systems, creating effective reporting methods, analysis of medication error reports, and recommendations to improve medication errors reporting systems. Methods: Electronic databases (PubMed, Ovid, EBSCOhost, EMBASE, and ProQuest) were examined from 1 January 1998 to 30 June 2020. 180 articles were found and 60 papers were ultimately included in the review. Data were mined by two reviewers and verified by two other reviewers. The search yielded 684 articles, which were then reduced to 60 after the deletion of duplicates via vetting of titles, abstracts, and full-text papers. Results: Studies were principally from the United States of America and the United Kingdom. Limited studies were from Canada, Australia, New Zealand, Korea, Japan, Greece, France, Saudi Arabia, and Egypt. Detection, measurement, and analysis of medication errors require an active rather than a passive approach. Efforts are needed to encourage medication error reporting, including involving staff in opportunities for improvement and the determination of root cause(s). The National Coordinating Council for Medication Error Reporting and Prevention taxonomy is a classification system to describe and analyze the details around individual medication error events. Conclusion: A successful medication error reporting program should be safe for the reporter, result in constructive and useful recommendations and effective changes while being inclusive of everyone and supported with required resources. Health organizations need to adopt an effectual reporting environment for the medication use process in order to advance into a sounder practice. Full article

(This article belongs to the Special Issue PROTAC—From Bench to Bed)

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Medicines, Volume 8, Issue 9 (September 2021) – 9 articles

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