Introduction: Lyme disease is the most common disease transmitted by ticks. In Poland, over 20,000 cases of this disease were diagnosed in 2019. The first vaccine approved to prevent this condition was Lymerix. Currently, we do not have any preparation registered for this purpose. Data from Phase 2 trials of VLA15 show strong immunogenicity in both adults and children, with an acceptable safety and tolerability profile in both study populations Aim: The purpose of this paper is to present the current state of the art in research into the VLA15 vaccine. Results: Phase 3 of the VALOR study has started. Ultimately, about 6,000 participants aged 5 and older are to take part in it. The experiment is conducted in a dozen or so sites located in areas where Lyme disease is highly endemic. Participants will receive three doses of VLA15 180 µg or a placebo in saline as the first series of vaccinations, followed by one booster dose of VLA15 or placebo in 0.9% NaCl (1: 1 ratio). Conclusion: Phase 2 studies on VLA15 showed promising results. Phase 3 of the research is ongoing. Key words: VLA15, Lyme disease, Borrelia
Introduction: Lung cancer is the number-one cause of death due to neoplasms worldwide. The 5-year overall survival rate is only 22%. In advanced stages, the therapeutic options are limited to chemotherapy, radiotherapy, molecularly targeted therapy and immunotherapy. Phytocannabinoids, the components of Cannabis sativa, their synthetic derivatives and endogenous cannabinoids have demonstrated anticancer activity in various common cancers - breast, prostate, colorectal and lung cancers, among others. The aim of this review was to assess the potential value of cannabinoids in the treatment of lung cancer. State of knowledge: The majority of preclinical studies demonstrates that cannabinoids inhibit lung cancer cell viability both in vitro and in vivo. The main mechanism of anticancer activity is the induction of apoptosis, triggered by activation of CB1, CB2 and TRPV1 receptors or independently via other pathways. Cannabinoids influence the components of the tumour microenvironment - cancer associated fibroblasts, macrophages and lymphokine-activated-killer cells. Cannabinoids alter leukocyte infiltration into anti-cancer proportions, inhibit expression of EGFR and PAI-1 and increase the expression of TIMP-1. As a result they induce cytotoxicity, decrease proliferation, migration and invasive potential of lung cancer cells, suppress angiogenesis and metastasis forming. Patients with advanced lung cancer may also benefit from analgesic, antiemetic and appetite improving properties of cannabinoids. Summary: Cannabinoids can be a supplementary agent in systemic anticancer therapeutic regimen in the future. The exact mechanisms of action, specific doses in anticancer treatment, routes of administration and interactions with other anticancer drugs has yet to be determined. Thus the clinical studies on cannabinoids in lung cancer should be performed in the future.
Objective: The study was aimed to analyze the diagnostic approach to a child with a non-traumatic musculoskeletal pain registered in the pediatric Hospital Emergency Department (HED). Since the pandemic COVID-19 affects patient health and the healthcare system, we also evaluated the impact of pandemic on type of musculoskeletal symptoms. Study design: A retrospective cross-sectional study was conducted by statistical analysis of data of patients with non-traumatic musculoskeletal pain registered in HED between January 2018 and December 2020. Data of patients referred and not referred to hospital ward and admitted to HED before and during COVID-19 pandemic have been compared. Results: Majority of patients presented acute, non-trauma related, single-site pain, usually localized in the hip, the knee and the spine. 21,49% of patients were referred to a hospital ward, usually rheumatological, neurological or orthopedic. Final diagnoses in almost ¾ patients belong to the group of musculoskeletal system and connective tissue disorders. During the pandemic significantly less patients with musculoskeletal pain reported to our HED. The duration of symptoms before admission was not significantly longer than in previous years, but the problem in children and the impact of the pandemic on the musculoskeletal system in children is complex. Conclusions: Our study provides detailed information on patterns of pediatric musculoskeletal consultations in HED. A positive history of trauma preceding musculoskeletal pain in a child may only be accidentally related to the final cause. Musculoskeletal pain can be also a symptom of a lot of various systemic conditions, not only diseases of the musculoskeletal system. The still ongoing COVID-19 pandemic may require changes in the organization of the HED. We believe that the presented results can help in organizing and planning care in pediatric HEDs, develop diagnostic algorithms and training for HED staff.
Introduction and purpose: This study aimed to discuss herbal supplement usage in population and possible harmful effects with a strong emphasis on the kidneys health. Materials and methods: A literature search was conducted in the PubMed MEADLINE database of medical publications using the following keywords: herbal nephropathy, aristolochic nephropathy, herbal supplementation, Chinese traditional medicine Results: Despite the widespread use of herbs among the general public, awareness of possible side effects appears to be negligible. The herbal medicine market is often unregulated, moreover, there are problems with correct identification of the plant, variable cultivation, its processing and the lack of accurate information about its biological activity. Possible side effects include frequent contamination of preparations with heavy metals, other substances such as hormones, aflatoxins or pesticides. In addition, herbs can directly affect the metabolism of drugs taken for specific medical indications. They are able to change the level of their absorption, metabolism in the liver and secretion. The kidneys are a special organ exposed to the harmful effects of herbs due to their high blood flow, resorption from the renal tubules and high metabolic activity. Among kidney damage, aristolochic nephropathy is the one worth mentioning, induced by the herb Aristolochia fangchi and causing a rapidly progressing kidney disease, largely ending up with the need for dialysis or kidney transplantation. Conclusion: The use of herbs as medical substances carries dangers. They should be prevented through proper education of the society, appropriate legal regulations and doctors' awareness of their occurrence.
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a common problem in adolescents and adults around the world. ADHD is particularly characterized by inattention, impulsiveness and hyperactivity, and in order to deal with these problems, patients often resort to other methods of treatment in addition to classic pharmacotherapy. Increasing numbers of ADHD patients are self-medicating with cannabis, despite the lack of specific evidence on its efficacy and safety. Aim of the study: The purpose of this study was to review the most recent available literature on the use of cannabidiol in the treatment of ADHD. For this purpose, PubMed and scopus databases were reviewed. The phrase "cannabidiol and ADHD" was used in the database search. After reviewing the titles and abstracts, 15 articles and articles cited in them were obtained and analyzed in detail. Results: Cannabinoids are reported to have pharmacological anxiolytic, neuroprotective, antidepressant, antipsychotic and hypnotic effects. Single-case studies of patients treated with them show that cannabinoids reduced hyperactivity, improved focus and control of impulsive behavior. Patients also reported side effects of cannabis use, the most common being mild short-term memory problems, dry mouth, sleepiness, and occasional experiences of constant thirst and greater forgetfulness. Most of the acute side effects were related to neuropsychiatric symptoms and were associated with cardiac sympathomimetic effects Conclusion: There is evidence for the effects of cannabinoids on ADHD symptoms as well as the influence of the cannabinoid system on involvement in neurological and psychiatric disorders. However, more controlled clinical trials are needed to determine the effect of cannabis use on ADHD symptoms and the norms of its use in this indication. Keywords cannabidiol, ADHD, literature review
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