Repurposing antivirals indicated for HIV/AIDS to treat COVID-19
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 21st, 2022
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Since the start of the pandemic, there has been huge efforts in developing antivirals for SARS-CoV-2. Remdesivir, initially a treatment for Ebola, and molnupiravir, originally used for Influenza, were repurposed for COVID-19. Thus, a recent study was conducted to investigate the possibility of using antivirals indicated for HIV to treat the COVID-19.
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Peripartum usage of benzodiazepine and the risk of attention deficit hyperactivity disorder and autistic spectrum disorder
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 19th, 2022
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Benzodiazepines are frequently prescribed to manage anxiety and depression in pregnant women. However, little is known about the effect of the medication on fetal neurodevelopment. Previous studies had shown that the molecule can be found in amniotic fluid and might affect the fetus. Thus, a large cohort study was conducted to understand the risk of neurodevelopmental abnormalities due to prenatal exposure to benzodiazepine.
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Ruxolitinib in treating patients hospitalized due to COVID-19
Topic: COVID-19
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 16th, 2022
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The severity of SARS-CoV-2 infection is highly associated with the degree of JAK/STAT pathway activation. Thus, inhibitors that target this pathway can potentially be used to reduce the unnecessary damage caused by the immune system. Ruxolitinib, which can bind and inactivate JAK protein, was investigated by a recent study for its ability to improve the clinical outcome of patients hospitalized due to COVID-19.
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Using butyrate supplements to manage obesity in children
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 14th, 2022
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Previous metabolomic studies had shown that butyrate is necessary for a healthy gut microbiome. Deficiency of this short chain fatty acid reduces the abundance of certain beneficial bacterial species; resulting in metabolic dysfunction and increasing weight gain. A recent clinical trial tested the efficacy of butyrate supplements in reverting childhood obesity.
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Examine the effectiveness of pacritinib in treating severe COVID-19
TOPIC: COVID-19
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 12th, 2022
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The acute respiratory distress disorder associated with severe SARS-CoV-2 infection is hallmarked by systemic inflammation mediated by elevated interleukin-6. Pacritinib, a JAK2/IRAK1 inhibitor that can reduce IL-6, had already been approved by the Food and Drug Administration to treat myelofibrosis. A study was conducted to investigate whether the immunosuppressive effect of pacritinib can be leveraged to treat COVID-19.
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Finding an alternative purpose for the antihypertensive medication, verapamil, in treating type 2 diabetes
TOPIC: DIABETES & ENDOCRINOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 9th, 2022
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Verapamil is a phenylalkylamine calcium channel antagonist that are frequently used to manage cardiovascular conditions such as arrhythmia, hypertension and angina. As an unintended effect, the agent inhibits the production of proapoptotic thioredoxin-interacting protein (TXNIP). Which overexpression leads to accumulation in the pancreas, resulting in increased oxidative stress that kills beta cells. A recent study has investigated the potential usage of Verapamil in managing type 2 diabetes.
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The effect of empagliflozin on the gut microbiome and cardiovascular health
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 7th, 2022
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Metformin is recommended as the first-line antihyperglycemic agent in most clinical guidelines, including the one published by the World Health Organization. In the United States, empagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT2i), is recommended by the Food and Drug Administration due to its cardiovascular benefit. A recently published study had investigated the health effect between patients metformin and empagliflozin.
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The effect of SGLT2i and GLP-1RA combination therapy in weight loss
TOPIC: DIABETES & ENDOCRINOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 5th, 2022
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The anti-diabetic medication, sodium-glucose cotransporter-2 inhibitors (SGLT2i), blocks glucose reabsorption in the kidney; this creates a calorie deficit and leads to weight loss. However, the rate of change is slower than predicted, and the loss can be reverted over time; this can potentially be explained by increased energy intake to compensate for the higher excretion. Glucagon-like peptide 1 receptor agonists (GLP-1RA) is another antidiabetic medication that acts on the central nervous system to suppress appetite. A recent study has investigated whether combining the two medications can create sustainable weight loss.
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Opioid agonist therapy in pregnant women, buprenorphine vs. methadone
Topic: OBGYN
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 2nd, 2022
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For pregnant women who are using opioids, to manage pain, opioid agonist therapy is usually initiated concurrently. This improves adherence to prenatal care and reduces the incidence of preterm birth, overdose, and death. Methadone and buprenorphine are the two commonly used opioid agonists; a recent study had compared their effect on maternal and fetal health.
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The potential usage of small interfering RNA agent, Olparisan, in treating elevated lipoprotein(a)
Topic: CARDIOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 30th, 2022
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Previous studies had reported on the causal relationship between elevated lipoprotein(a) - LP(a) - level and diseases such as atherosclerosis & calcific valvular aortic stenosis. However, there is currently no therapeutic agent approved to lower lipoprotein(a) concentration. LP(a) concentration is dependent on the expression of the LPA gene, and Olpasiran is a small interfering RNA (siRNA) that can interfere with its LPA transcription. Results from a study investigating the effect of Olpasiran on LP(a) level had recently been published.
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Bepirovirsen effectiveness and safety in treating chronic hepatitis B infection
Topic: INFECTIOUS DISEASE
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 28th, 2022
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Bepirovirsen is an antiviral agent created by the pharmaceutical company GlaxoSmithKline which is being investigated for its ability to interfere with the replication cycle of the Hepatitis B virus. Being an antisense oligonucleotide, Bepirovirsen works by binding to HBV RNA and negates its interaction with other viral proteins; thus, the agent interferes with the viral life cycle. A previous phase 2a trial has shown that a 4-week therapy results in a substantial drop in hepatitis B surface antigen (HBsAg) level. The same research group had conducted a follow-up study, with a longer surveillance period, and they had recently published their findings.
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Cardiovascular effect of lowering triglyceride level with pemafibrate
Topic: CARDIOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 25th, 2022
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Increased blood triglyceride level is correlated with a higher risk of cardiovascular accidents such as myocardial infarction and ischemic stroke. However, it is unclear if lowering its concentration can improve the patients’ clinical prognosis. A study, recently published in the New England Journal of Medicine, had reported on the cardiovascular effect of lowering blood triglyceride level.
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Raltegravir-based combined antiretroviral therapy and weight gain in HIV-positive pregnant women
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 23rd, 2022
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Reducing viral load is extremely essential for HIV-positive women who are pregnant; thus, raltegravir was recommended due to its low toxicity. Studies conducted on non-pregnant adults and adolescents had reported that the antiretroviral induce weight gain. For pregnant women, this can increase the risk of peripartum diabetes, peripartum hypertension, postpartum weight retention, etc. This can also affect the fetus by causing macrosomia, offspring obesity, which increase the likelihood of cesarean delivery. A recent study had reported on the risk of peripartum weight gain of HIV-positive pregnant women who are using raltegravir.
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The risk of Herpes Zoster infection after COVID-19 immunization
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 21st, 2022
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Due to the controversial nature of COVID-19 and immunization, the public has an intense interest toward its adverse events. At the same time, there has been an increase in the number of herpes zoster viral infections reported. It is uncertain if there is an actual increase in risk, or this higher rate of detection is due hypervigilance. A recent study had improved our understanding about the safety profile of the COVID-19 vaccine by analyzing its relationship with Herpes Zoster infection
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In vitro fertilization-embryo transfer does not increase the risk of mother-to-infant transmission of Hepatitis B
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 18th, 2022
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For in vitro fertilization-embryo transfer (IVF-ET), maternal oocytes are retrieved and fertilized in vitro before implantation to the uterus. Thus, embryos can potentially be infected with Hepatitis B virus (HBV) carried by the infected mother. A recently published study had reported on the likelihood of mother-to-child transmission (MTCT) of HBV in women that had become pregnant using IVF-ET.
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The risk of severe acute respiratory infections and COVID-19 in patients with neuropsychiatric disorder
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 16th, 2022
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Previous cohort studies had found that patients with severe neuropsychiatric disorders such as anxiety, schizophrenia, and depression are at a greater risk of developing severe acute respiratory infections (SARI), including COVID-19. In addition, it has been reported that the usage of certain neuropsychiatric drugs increases the susceptibility to airway infections. Since COVID-19 is becoming endemic, a study has been conducted to understand the risk profile of certain neuropsychiatric conditions and treatments.
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Intravenous amino acids supplementation to prevent neurodisability in preterm infants
Topic: PEDIATRIC
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 14th, 2022
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Amino acids are essential for the process of neurodevelopment, and a daily dose of 3-4 g is recommended. Because the brains of preterm children are underdeveloped, it is possible that a higher than average dosage is required. Prior observational studies have shown that there is a positive correlation between protein intake and the level of neurodevelopment; however, the appropriate dosage for preterm infants is not known. A study conducted by the ProVIDe research group had reported on the effect of amino acids supplementation on neurodevelopment.
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The potential for using psilocybin to treat patients with major depressive disorder
Topic: PSYCHIATRY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 11th, 2022
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Previous study had reported that the usage of psilocybin in treating cancer also elicits an antidepressant effect. The compound can be isolated from several species of mushroom, and consumption for recreational purposes can result in euphoria and hallucination. Due to its ability to induce an euphoric sensation, psilocybin can potentially be used to treat patients with major depressive disorder. A recent phase 2 clinical trial had reported on the effect of single-dose psilocybin therapy in treating patients with major depressive disorder that had not been responsive to other treatment.
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Potassium & magnesium supplementation therapy in treating atrial fibrillation and flutter
Topic: CARDIOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 9th, 2022
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Low level of magnesium and potassium leads to an overabundance of calcium; this electrolyte overload can prolong the duration of the action potential phase and trigger afterdepolarization too early. Previous studies had reported that off-scheduled depolarization can lead to the development of atrial fibrillation (AF). Thus, it is possible that supplementation of magnesium and potassium can restore electrolyte balance and prevent AF; however, there is currently no clinical guideline supporting or discouraging this therapy. A recent study had reported on the possibility of using potassium and magnesium to induce spontaneous conversion to sinus rhythm in patients that have atrial fibrillation and atrial flutter (AFL).
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Kisspeptin is a promising therapy for osteoporosis in men
Topic: ORTHOPEDIC
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 7th, 2022
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Human bone constantly undergoes a process of formation and resorption. Disruption to this homeostasis is the pathophysiological cause behind osteoporosis. Thus, agents which inhibit the process of bone resorption carried out by osteoclasts can potentially be used to slow down the process of bone loss and prevent osteoporosis. A recent study had reported that kisspeptins can act on osteoclasts, reducing the resorption efficiency; thus, it can potentially be used to treat osteoporosis.
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The effectiveness and safety of the Moderna mRNA-based COVID-19 vaccine in children older than 6 months
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 4th, 2022
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In mid-June of 2022, the US Food and Drugs Administration recommended the usage of COVID-19 vaccines for children above the age of 6 months. Later in July of the same year, the Ministry of Health in Vietnam made the same recommendation. A recent multicenter study conducted in the United States and Canada had investigated the efficacy and safety of the mRNA-1273 vaccines manufactured by Moderna.
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Upadacitinib vs. Dupilumab in treating moderate-to-severe atopic dermatitis
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on November 2nd, 2022
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Atopic dermatitis is majorly driven by the pro-inflammatory signal transduced by Interleukin-4. Thus, dupilumab, an antibody targeting IL-4 receptors has been used to treat the condition; however, only half of them achieve skin clearance after 16 weeks of usage. Thus, upadacitinib, a small molecule JAK inhibitor, can be a better alternative due to its broader spectrum of activity. Upadacitinib had already been approved for usage to treat patients with rheumatoid arthritis; thus, a comparative study was conducted, and its result had been published in the Journal of the American Medical Association - Dermatology.
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Monoclonal antibody nirsevimab is effective in preventing respiratory syncytial virus infection in term and late preterm infants
Topic: PEDIATRIC, INFECTIOUS DISEASE
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 31st, 2022
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Nirsevimab is a monoclonal antibody designed to bind to the fusion protein on the surface of respiratory syncytial virus (RSV). Thus, it had been approved for preventing RSV infection in preterm infants. A study sponsored by the pharmaceutical companies MedImmune/AstraZeneca and Sanofi had reported on the effectiveness of nirsevimab at preventing RSV infection in term and late preterm infants.
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Ivermectin is not effective at managing SARS-CoV-2 infection
Topic: COVID-19
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 28th, 2022
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The usage of ivermectin to prevent and manage SARS-CoV-2 infection had been controversial since the start of the pandemic. Thus, many studies have been conducted to investigate the efficacy of the antiparasitic agent. Supporting the current literature, an article recently published in the Journal of the American Medical Association had reported on the effectiveness of ivermectin on relieving symptoms of mild to moderate COVID-19 in adults being treated in an outpatient setting.
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Gastrointestinal complication is associated with more severe COVID-19 infection in children
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 26th, 2022
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Due to tropism of SARS-CoV-2 receptors, the virus can only enter host cells that express angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). Besides the respiratory tract, these host cell’s proteins can be found on enterocytes; this cellular mechanism can explain why virus particles can be shed with feces, and gastrointestinal (GI) manifestations had been reported in COVID-19 cases. However, the frequency of these GI symptoms is unknown. A study had reported on the prevalence of gastrointestinal problems in children diagnosed with COVID-19
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Vonoprazan can be suitable replacement for lansoprazole in treating erosive esophagitis
Topic: GASTROINTESTINAL
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 24th, 2022
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Proton pump inhibitors (PPI), such as lansoprazole, are the gold standard therapy for erosive esophagitis; however, prior study had reported a failure rate range between 5% and 20% that increased to 30% with those with severe esophagitis. Thus, alternative therapies should be used for these patients; potassium-competitive acid blocker (PCAB) is a possible substitute. With a longer half life and a wider spectrum of action, PCAB can be an effective treatment. A multi-site study had compared the efficacy between lansoprazole and a PCAB in the form of vonoprazan.
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Ruxolitinib cream helps with skin repigmentation in those who had been diagnosed with vitiligo
Topic: DERMATOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 21st, 2022
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The skin depigmentation of vitiligo is caused by the destruction of melanocytes by CD8+ T cells. These lymphocytes are recruited by the Interferon-γ-driven overstimulation of the JAK-STAT pathway at the affected sites. A previous stage II clinical trial had reported that the JAK-inhibiting agent, Ruxolitinib, can help increase the rate of skin repigmentation. The result from the follow-up phase III trial had been released to provide more insight on the efficacy of the ruxolitinib cream.
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Supplementation of D-cycloserine to intermittent theta-burst transcranial magnetic stimulation therapy helps reduce the severity of depression
Topic: PSYCHIATRY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 19th, 2022
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Past studies had reported that transcranial magnetic stimulation, such as with intermittent bursts of theta wave, can be used to treat major depressive disorder. The efficacy of these methods are dependent on synaptic plasticity; thus, supplementation with regulating agents can be beneficial. D-cycloserine is a partial agonist to the N-methyl-D-aspartate (NMDA) receptor on the postsynaptic membrane that regulates synaptic plasticity. A study conducted by researchers and clinicians at the University of Calgary had reported that supplementation with this agent helps with treating depression.
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Peripartum usage of antidepressants is not associated with higher risk of neurodevelopmental disruption to the children.
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Reviewed by Nhi Le, B.A, ScM.
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Posted on October 17th, 2022
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Because the effect of antidepressants during pregnancy is unknown, many expecting mothers give up their therapy due to their concern over the potential impact on their children's neurodevelopment. Compounded with stress due to peri- and post- partum factors, the psychological health of these mothers are worsen, and this can directly affect their relationship with the neonates. A recent study published in the Journal of the American Medical Association had assessed the effect of peripartum antidepressant usage on the neurodevelopmental and psychological health outcomes of children.
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Using acetazolamide to treat acute decompensated heart failure
Topic: CARDIOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 14th, 2022
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Acetazolamide is a carbonic anhydrase inhibitor that can act on the proximal tubule to induce sodium reabsorption. Thus, the agent can increase diuretic efficiency and reduce fluid accumulation. An article recently published in the New England Journal of Medicine had reported on the efficacy of acetazolamide in patients with acute decompensated heart failure with volume overload.
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Combining ezetimibe with statin in treating non-alcoholic fatty liver disease (NAFLD)
Topic: GASTROINTESTINAL
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 12th, 2022
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Highly potent statin, such as rosuvastatin, is the first-line therapy for non-alcoholic fatty liver disease (NAFLD). However, these powerful statins, especially in high doses, carry with them a battery of side effects. Thus, it is essential to find complementary agents with minimal collateral effect to substitute for high-dose statin. A study conducted by physicians and scientists at Yonsei University had reported on the potential of adding ezetimibe to the current therapy.
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Peripartum COVID-19 vaccination is safe and beneficial for mothers and neonates
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 10th, 2022
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Currently, very little is known about the effect COVID-19 vaccination has on pregnancy. Thus, many unreliable sources have claimed that immunization is unsafe for the mother’s and fetus’s health. A recent literature review published in the Journal of the American Medical Association had reported on the safety profile of COVID-19 vaccination on pregnancy.
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The combo of Cefepime/Enmetazobactam is more effective than Piperacillin/Tazobactam at treating complicated urinary tract infection and acute pyelonephritis
Topic: INFECTIOUS DISEASE
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 7th, 2022
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To counter the high rate of resistance against β-lactam class antibiotics, β-lactamase inhibitors are usually used as a complement agent. The piperacillin/tazobactam combination is frequently used to treat serious bacterial infections such as complicated urinary tract infection and pyelonephritis. However, due to possible antibiotic resistance against these medications, new agents should be assessed for their efficacy. A recent study published in the Journal of the American Medical Association had made the comparison between the current standard therapy to the Cefepime/Enmetazobactam combo.
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Emollient usage to prevent atopic dermatitis in neonates
Topic: ALLERGY & IMMUNOLOGY, DERMATOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 5th, 2022
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As Vietnam is undergoing an epidemiological transition, we can see an increase in childhood allergic condition frequency alongside the drop in communicable disease. Thus, it is essential to increase our understanding about the best treatment for these conditions. A recent study had reported the efficacy of early-life emollient usage on preventing atopic dermatitis.
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The effectiveness of Tazarotene 0.045% lotion in treating acne vulgaris
Topic: DERMATOLOGY
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on October 3rd, 2022
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Retinoid, a derivative of vitamin A, is a first-line treatment for acne lesions by preventing keratinocyte proliferation and differentiation. There are many types of medication in the retinoid class; each targets a few specific subtypes of retinoid receptors and have their own tolerability profile. A recent review article had recently published their findings on the efficacy and safety of Tazarotene, a retinoid that targets 2 of the 6 receptors.
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