Pharmacology
Mechanism of Shashen Maidong Decoction in the Treatment of Radiation Pneumonitis Based on Network Pharmacology and Molecular Docking
Radiation therapy is a crucial method used to treat various tumors but it can lead to radiation pneumonitis. Shashen Maidong Decoction (SMD) is clinically used to treat radiation pneumonitis but the exact mechanism remains unclear.
Herbal components and targets of SMD were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) the Encyclopedia of Traditional Chinese Medicine (ETCM) and Swiss Target Prediction platforms. Moreover disease-related targets were retrieved from the GeneCards database. A Protein-protein Interaction (PPI) network was constructed using the STRING database and analyzed using the Cytoscape software. In addition Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed using the DAVID database. Subsequently the disease-active component-target network and drug-pathway-target network were constructed using Cytoscape. The molecular docking results were validated and visualized using Auto Dock and PyMOL software.
In this study 115 conserved active ingredients 316 drug targets and 355 radiation pneumonitis targets were identified. Among these 75 targets were identified as intersecting targets. GO enrichment analysis revealed 494 biological processes 36 cell components and 59 molecular functions. KEGG analysis uncovered 118 signaling pathways including the IL17 signaling pathway TNF signaling pathway HIF-1 signaling pathway etc. The molecular docking results showed the core active ingredients of SMD including quercetin kaempferol beta-carotene and naringenin to have strong binding ability with the core targets.
This study preliminarily confirmed that SMD may act on the TNF IL17 and HIF-1 signaling pathways to exert its therapeutic effects on radiation pneumonitis by regulating the expression of inflammatory factors.
Production, Characterization, and Molecular Dynamic Study of Antidiabetic and Antioxidative Peptides of Fermented Cheese Whey with Anti-inflammatory Properties using Limosilactobacillus fermentum
This study aims to valorise cheese whey waste by converting it into bioactive peptides that have several health benefits potentially leading to the development of nutraceuticals and functional foods and also used in the pharmaceutical industry.
The study evaluates the antidiabetic antioxidative and anti-inflammatory properties of fermented cheese whey with Limosilactobacillus fermentum (M4) along with the production of antioxidative and antidiabetic peptides. SDS-PAGE and 2D-PAGE were also performed to identify proteins by molecular weight and isoelectric point while RP-HPLC distinguished peptide fractions. Peptide sequences from 2D gel spots were identified using RPLC/MS and RP-HPLC analyzed 3 kDa and 10 kDa permeates. Peakview software characterized the LC/MS results and FTIR analysis measured structural changes in bioactive peptides.
The antioxidative and antidiabetic properties in cheese whey fermented with M4 showed a progressive growth over extended incubation periods higher effects were observed after fermentation for 48 hours. Inhibitory activities in α-glucosidase α-amylase & lipase were found to be 65.39% 66.09% and 56.74% respectively. ABTS assay was performed to measure antioxidant activity (63.39%) and the highest proteolytic activity (7.62 mg/ml) was measured at 2.5% inoculation rate for 48 hours. In SDS-PAGE protein bands between 10 & 30 kDa were observed whereas peptide spots within the range of 10 to 70 kDa were also visualized on the 2D-PAGE. RP-HPLC was used to distinguish different fractions of a peptide. Peptide sequences from 2D gel spots were identified using RP-HPLC & RPLC/MS. Peakview software was utilized to characterize the LC/MS results. Sequences of peptides generated from α-lactalbumin and β-lactoglobulin were searched in the BIOPEP database to validate the antidiabetic and antioxidative activities of fermented cheese whey peptides. LPS-fermented cheese whey at a concentration of 0.50 mg/mL significantly suppressed the production of pro-inflammatory cytokines as well as the mediators that govern them including IL-6 IL-1β NO and TNF-α in RAW 264.7 cells. FTIR was used in the analysis of protein secondary structure and conformational changes.
This study aims to produce antidiabetic and antioxidative peptides from dairy waste and cheese whey.
Astragalus Injection Modulates the Pharmacokinetics of Doxorubicin and CYP450 Enzymes
Doxorubicin (DOX) is a widely used anthracycline antibiotic for the treatment of breast cancer liver cancer lymphoma and other malignant tumors. However its clinical application is limited by the side effects and drug resistance. Astragalus injection has been combined with DOX in the treatment of cancer which improves the curative effect and reduces drug resistance. This study investigated the interaction between DOX and Astragalus injection and elucidated the potential mechanism.
The pharmacokinetics of DOX injection (7 mg/kg intraperitoneal injection) with or without Astragalus injection (4.25 mL/kg/day for 14 days intraperitoneal injection) were investigated in plasma from male Sprague-Dawley rats (n = 6) by UPLC-MS/MS. The group without the Astragalus injection was set as the control group. Additionally the effects of Astragalus injection on CYP450 enzyme activities were assessed using a rat liver microsome incubation system with cocktail probe drugs.
Astragalus injection significantly increased the Cmax (2090.01 ± 99.60 vs. 5262.77 ± 111.15 ng/mL) and AUC0-t (1190.23 ± 104.43 vs. 3777.27 ± 130.55 μg/L × h) and prolonged the t1/2α (0.09 ± 0.02 vs. 0.14 ± 0.04 h) of DOX. Astragalus injection significantly inhibited the activity of CYP1A2 CYP2C9 CYP2E1 and CYP3A4 and enhanced the activity of CYP2D1 with a metabolic elimination rate of 30.11 ± 2.67% vs. 19.66 ± 3.41% 35.95 ± 2.57% vs. 23.26 ± 3.57% 13.43 ± 2.56% vs. 9.06 ± 2.51% 47.90 ± 6.30% vs. 25.87 ± 2.55% 17.62 ± 1.49% vs. 24.12 ± 2.91% respectively (p < 0.05).
The co-administration of DOX and Astragalus injection alters the systemic exposure of DOX by affecting the metabolism of DOX and the activity of CYP450 enzymes. These findings highlight the importance of drug-drug interactions when combining Astragalus injection with DOX and provide a basis for optimizing combination therapies to address DOX resistance and toxicity.
Unraveling the Pivotal Role of Nanovesicle Drug Delivery Systems in Colorectal Cancer: A New Paradigm in Therapeutics
Colorectal cancer is a highly prevalent gastrointestinal malignancy leading to mortality. The prolonged efficacy of chemotherapeutic medications has been hindered by their limited capacity to reach the intended target their lack of specificity in targeting tumors their non-specific dispersion throughout the body and limited availability at the tumor location and their undesired adverse effects. Targeted drug delivery to the colon enhances drug concentration at the desired location resulting in a reduced dosage requirement and consequently fewer side effects. This review article provides a thorough discussion of the numerous pathways that may cause colorectal cancer. The concept of drug targeting in colorectal cancer using nanovesicles has been addressed in detail in this article. This can be accomplished either by passive targeting or active targeting through receptor-ligand interaction by attaching certain active targeting moieties such as folic acid epidermal growth factor receptor GE-11 peptide EpCAM aptamer and transferrin over the surface of nanovesicle. This review showcases applications of nanovesicle systems such as liposomes phytosomes polymeric micelles niosomes cubosomes emulsomes polymersomes and lipopolymersomes in drug delivery for the management of colorectal cancer. The nanovesicle systems have significant potential in managing colorectal cancer and overcoming the challenges encountered with current therapy methods.
An Updated Review Deciphering the Inhibitory Potential of Erianin via Targeting Several Dysregulated Oncogenes in Several Human Carcinomas
Numerous edible vegetables and fruits possess plant-based compounds with enormous anti-carcinogenic attributes including phenolic vitamins and alkaloid compounds. Cancer therapies mainly encompass surgery chemotherapy and radiation therapy sometimes accompanied by rapid recurrence and significant side effects. Consequently elucidating efficacious chemotherapeutic procedures are needed to diminish the likelihood of recurrence and metastasis. Erianin (Shihu Traditional Chinese Medicine) a naturally occurring compound derived from Dendrobium chrysotoxum Lindl. has been documented to possess anticancer and antioxidative properties. This review presented an overview of Erianin's (ER) involvement in cancer and elucidated the molecular mechanisms underlying its anticancer effect via regulating signaling pathways including PI3K/AKT MEK JNK NRF2/PLOOH JAK/STAT3 GSK3β and NLRP3/ROS pathways. All these mechanisms ultimately induce apoptosis via targeting mainly invasion migration and angiogenesis. This review is thus intended to include all possible recent progress in the anticancer efficacy of erianin and to justify the necessity for further investigation into its anticancer properties in the future.
Data-independent Acquisition Mass Spectrometry Reveals Exosomal LAMC1 as a Key Determinant of Lung Adenocarcinoma Radiosensitivity, Independent of EGFR Mutation
This study is formulated to reveal the variables affecting the radio-sensitivity in lung adenocarcinoma (LUAD).
LUAD patients show varied radiotherapy responses. While epidermal growth factor receptor (EGFR) mutations are often used to predict sensitivity their reliability is debated underscoring the need for better biomarkers.
The aim of this study was to identify key functional proteins that regulate the sensitivity of LUAD to radiotherapy and to assess the potential value of exosomal LAMC1 as a clinical predictive marker.
In this study 103 LUAD patients receiving concurrent radiotherapy were included to assess the relationship between EGFR mutation and survival. Intrinsic radio-sensitivity and different radio-sensitivities in 14 LUAD cell lines with/out EGFR mutation were examined based on the surviving fraction at 2 Gy (SF2). Data-independent acquisition (DIA) and Liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based proteomics were used to investigate the proteomics of the LUAD cell lines. Subsequently GO/KEGG enrichment analysis was combined with protein-protein interaction (PPI) network screening for key proteins. Nano-flow cytometry was employed to validate changes in radiosensitivity-associated protein expression within exosomes while siRNA-mediated knockdown was performed to assess the functional impact of specific proteins on LUAD cells.
EGFR mutations were not significantly associated with progression-free survival (PFS)/overall survival (OS). 14 LUAD cell lines displayed intrinsic variations in SF2 and no difference between the EGFR mutation and wild-type groups was reported. 5425 proteins were identified via DIA in 14 LUAD cell lines. After bio-informatics analysis LAMC1 ITGB4 ITGA6 and CD44 were the most representative core differential proteins for the radio-sensitivity in LUAD cells. Notably LAMC1 was confirmed as a radiation-resistant protein. Following radiotherapy LUAD cells secreted exosomes with reduced LAMC1 levels. Moreover LAMC1 knockdown significantly affected cellular proliferation and apoptosis following the irradiation.
LAMC1 serves as a critical functional determinant of radiotherapy resistance in LUAD. Its dynamic changes in exosomes demonstrate potential for predicting radiotherapy response suggesting clinical utility for radiosensitivity assessment and personalized radiotherapy guidance.
A Spotlight on PLGA-based Nanoparticles: Pioneering a New Era in the Therapeutics of Cardiovascular Disorders
Cardiovascular disorders (CVDs) are the primary cause of mortality globally and the community is significantly affected when young people suffer from CVDs. Coronary artery disease myocardial infarction fibrosis atherosclerosis pulmonary arterial hypertension thrombosis and ischemic diseases are different types of CVDs which encompass a wide range of conditions that interfere with the functioning of the cardiovascular system. The relevance of nanotechnology in the treatment of CVDs has emerged progressively in previous decades.
This review offers concise insights into the physiochemical characteristics of poly (lactic-co-glycolic acid) (PLGA) imperative for drug delivery. This article highlights the application of PLGA-NPs in myocardial ischemia atherosclerosis myocardial infarction pulmonary artery hypertension valvular heart disease tumour thrombus cardiac myocyte restenosis cardiovascular theranostics vascular disorders and angiogenesis. Further this review gives updates about published patents pertaining to the current state-of-art about PLGA-NPs in CVDs.
An extensive review was undertaken employing the Google Scholar PubMed and ScienceDirect databases using scientific papers published in peer-reviewed journals from 2000 to 2024.
Owing to their minuscule size and increased surface area accessible for surface functionalization the PLGA-NPs offer a cutting-edge technology to provide an efficient platform for controlled and targeted drug delivery therefore imparting tremendous relevance in reducing the occurrence of CVDs.
This has been concluded that PLGA is the highly effective biodegradable copolymer also known as “Smart polymers” because of their biodegradability biocompatibility controlled drug release profile and potential for surface modification with targeting molecules.
Trends in 4D Printed Shape Memory Biomaterials for Tissue Engineering Applications
Shape memory polymers and stimuli-sensitive materials are utilised in 4D printing to develop tissue structures that are dynamic and flexible. The capability of these polymers to react to numerous stimuli like pH light and temperature increases the adaptability and usefulness of tissue engineering applications. The article aims at the application of smart SMPs in 4D printing for tissue engineering emphasising their response to diverse physical and chemical stimuli. The current review article compiled data from previously reported studies by searching in commonly used electronic databases such as Scopus Google Scholar PubMed Science Direct etc. The authors have preferably considered the data from the last 10 years for inclusion. The study addresses developments in smart shape memory polymers and their transformational influence on biological applications. The integrated approach of 4D printing and shape memory biomaterials can potentially improve tissue engineering applications. Researchers can enhance tissue regeneration by utilising the responsive properties of these materials to physiological signals. This allows for the design of dynamic scaffolds that closely imitate the behaviour of real tissue resulting in more efficient tissue regeneration. 4D-printed shape memory biomaterials have the potential to enhance tissue engineering via the use of dynamic and adaptable scaffolds. However some obstacles must be overcome such as material limitations and the capacity to scale up production to achieve successful clinical implementation.
Unveiling Promising PARP12 Inhibitors through Virtual Screening for Cancer Therapy
Poly (ADP-ribose) polymerase 12 (PARP12) plays a crucial role in DNA damage response (DDR) through DNA repair maintaining genomic stability. Mutations in PARP12 contribute to genomic instability leading to cancer progression. Targeting PARP12 mutants with small molecule inhibitors offers a promising therapeutic strategy.
This study aims to identify potent inhibitors for PARP12 mutants using molecular docking-based virtual screening from the National Cancer Institute (NCI) compound library followed by molecular dynamics (MD) simulations to validate binding stability.
Homology models of human PARP12 mutants were developed for virtual screening. The top-scoring compounds were refined through molecular docking and their stability was analyzed using all-atomistic MD simulations. Binding free energy (MMGBSA) calculations and structural dynamics assessments including RMSD RMSF RoG and SASA were conducted to evaluate the drug-receptor interactions.
Three promising inhibitors NCI-32743 NCI-32982 and NCI-659779 demonstrated high binding affinity and stability with PARP12 mutants. These compounds showed significant inhibitory potential maintaining strong interactions with the target protein throughout the simulation period. ADMET and pharmacokinetic analyses confirmed their drug likeness and potential for further development.
The identified inhibitors exhibit strong potential for targeting PARP12 mutants in cancer therapy. Further in vitro and in vivo studies are required to confirm their efficacy and therapeutic viability for clinical applications.
The Associations between Albumin, Globulin, Albumin-to-globulin Ratio, and Frailty in Middle-aged and Older Adults: Evidence from NHANES 2013-2014
Inflammation and nutritional status have significant roles in frailty. While albumin and the albumin-to-globulin ratio (AGR) are recognized as inflammatory and nutritional biomarkers and globulin is associated with inflammation their relationships with frailty remain underexplored. This study explored the relationships between albumin globulin AGR and frailty among middle-aged and older adults utilizing data from the National Health and Nutrition Examination Survey (NHANES) database.
The study was a cross-sectional study with participants aged ≥45 years from the 2013-2014 NHANES database. The frailty assessment was based on a 36-item index of frailty constructed in NHANES excluding nutritional indicators. The relationships between albumin globulin AGR and frailty were analyzed using weighted multivariate regression analyses smooth curve fitting two-segment linear regression models subgroup analyses and interaction tests.
This study involved 1506 middle-aged and older participants with a frailty rate of 42.23%. Nonlinear relationships were identified between albumin AGR and frailty while a linear relationship was observed between globulin and frailty. Two-segment linear regression models demonstrated that the inflection points for albumin and AGR were 3.90 and 1.91 respectively. On the left side of these inflection points albumin and AGR were negatively associated with the prevalence of frailty. On the right side of these inflection points albumin and AGR were not significantly associated with the prevalence of frailty.
This study reveals two threshold effects on frailty in middle-aged and older adults: albumin and AGR. Below specific thresholds both are linked to reduced frailty risk but above these levels neither shows a significant association. Globulin however consistently correlates with increased frailty. These findings highlight nonlinear relationships between albumin AGR and frailty suggesting that maintaining optimal levels of these biomarkers may help prevent frailty.
A Split-Mouth, Randomized, Double-Blind Clinical Trial of a Gelatin Hemostatic Dental Sponge Containing Aloe Vera Nanoparticles for Controlling Bleeding After Mandibular Posterior Teeth Extraction
Hemostatic dental sponges are biodegradable materials and fast hemostats that can help blood clotting in the surgical site and quick repair of the dental surgery site. In this study we investigated the bleeding control (blood absorption ability and active bleeding) of a hemostatic gelatin sponge containing aloe vera nanoparticles as a hemostatic material after the removal of mandibular posterior teeth in a double-blind randomized trial.
A clinical trial was performed on 30 patients (13 males and 17 females) who were referred to the Department of Oral and Maxillofacial Surgery Faculty of Dentistry for extraction of two mandibular molars. The plan was a split-mouth randomized double-blind clinical trial. To investigate the blood absorption ability of a hemostatic sponge containing aloe vera nanoparticles in each patient after tooth extraction the sponge was placed in the socket of the extracted tooth. Sterile gauze was placed on the hemostat sponge containing aloe vera nanoparticles (test group). For the control group the same process was repeated with a sponge without aloe vera nanoparticles. The number of used sterile gauzes was recorded and the mean excess blood weight was measured with a digital scale. Also the amount of bleeding after 1 and 4 hours of tooth extraction was recorded for all patients as an active bleeding time.
The number of sterile gauzes used and the mean excess blood weight used in each group indicate blood absorption. The results showed that there was no significant difference in the amount of sterile gauze between the two groups (P=0.65). In both groups the consumption of three sterile gauzes was the most frequent. However the mean excess blood weight in the control group was significantly higher which indicates the better efficiency of the test group (P=0.04). Besides the examination of the patients showed that in none of the patients of the two groups active bleeding was observed 1 and 4 hours after tooth extraction.
The performance of the test sponge was better than the control sponge in controlling bleeding after tooth extraction. It seems that the obtained results cannot only be related to the presence of aloe vera nanoparticles. The differences in the bleeding control (blood absorption ability and the active bleeding time) for the used sponges can also influence the results. In addition the use of aloe vera in the form of nanoparticles can contribute to early healing effects and other beneficial effects such as antimicrobial effects in the tooth-extracted site.
Ciprofloxacin’s Structure Causing Fluoride-Related Toxicity: A Case Report
Ciprofloxacin is a fluoroquinolone antibiotic widely used in clinical practice with a fluorine atom in its chemical structure. Like other antibiotics it can induce several adverse effects such as tendinopathy musculoskeletal toxicity peripheral neuropathy and cardiotoxicity thereby causing relevant and irreversible health injuries. Ciprofloxacin fluoride's adverse toxicological effect associated with a urinary fluoride concentration above the reference value has not yet been reported.
This case report aimed to provide evidence of ciprofloxacin treatment intoxication an antibiotic containing a fluorine atom in its chemical structure associated with a fluoride urine concentration above the reference value.
A 32-year-old man developed tendinopathy and peripheral neuropathy on the third day’s night after initiating the ciprofloxacin doses exhibiting symptoms comparable to a low-power electrical discharge and very intense motor agitation. After following habitual laboratory exams a urinary fluoride measurement was performed by an ion-selective electrode. The urinary fluoride concentration was above the reference values in mg/g of creatinine.
This is the first study that has described an association among ciprofloxacin-fluoride tendinopathies and peripheral neuropathy. The patient's symptomatology has suggested a toxic effect related to fluoride. We consider the documented finding of a fluorine atom at the ciprofloxacin structure and its toxic potential neuropathies and tendinopathies as an issue of alert.
Extreme and Severe Systemic Pain Caused by Rifampicin: A Case Report of a Rare Allergic Reaction
Rifampicin is a first-line anti-tuberculosis drug but it may cause severe allergic adverse reactions.
This case report describes an unusual and severe adverse reaction to rifampicin in a 53-year-old male patient with pulmonary tuberculosis. The patient developed intense systemic pain within 4 hours of rifampicin administration affecting multiple organs and joints without typical allergic manifestations such as fever or rash. The pain progressively worsened over three consecutive days of treatment reaching its peak intensity (NRS score 8/10) on the third day with pain duration extending from 3 to 8 hours. The severe pain was characterized as sharp and burning in nature significantly impacting the patient's daily activities and mobility. A subsequent rifampicin challenge test (single dose 0.45g) confirmed the causal relationship by reproducing identical severe pain symptoms. The Naranjo adverse drug reaction probability scale yielded a score of 7 indicating a “probable” causal relationship. Notably the patient exhibited underlying autoimmune abnormalities (positive ANA and elevated ESR) which may have contributed to the severity of the reaction through enhanced inflammatory responses and altered pain mechanisms. The symptoms completely resolved upon rifampicin discontinuation and alternative treatment with levofloxacin proved successful with no pain recurrence during the four-month follow-up period.
This case highlights a previously unreported presentation of rifampicin hypersensitivity and emphasizes the importance of careful risk assessment in patients with autoimmune features before initiating rifampicin therapy.
A Rare Case of Fatal Toxic Epidermal Necrolysis (TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome in a Patient with Rheumatoid Arthritis
This case study presents a rare and fatal instance of Toxic Epidermal Necrolysis (TEN) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome in a 51-year-old male patient diagnosed with Rheumatoid Arthritis (RA).
The patient was initially treated with sulfasalazine leflunomide and hydroxychloroquine following which he developed a rash fever and loose stools. Drug allergy was suspected and the anti-rheumatic medications were withdrawn following which the patient improved. A subsequent attempt was made to treat the RA with methotrexate prednisolone and hydroxychloroquine following which the rash returned along with an increase in severity including detachment of the epidermis and mucosa and systemic involvement both hepatic and renal. The patient ultimately succumbed to multiple organ dysfunction syndrome and neutropenic sepsis.
This case highlights the possibility of DRESS syndrome and Stevens-Johnson Syndrome (SJS)/TEN following treatment with anti-rheumatic medications. Evidence of this is rare with the exception of sulfasalazine. This case also considers that the signs of a moderately severe adverse drug reaction could be the early warning signs of DRESS syndrome which can be difficult to manage and may turn fatal. Additionally this case highlights the need for maintenance of quality health records in low- and middle-income countries due to the failure to identify hydroxychloroquine as a suspected drug inducing the initial adverse reaction that resulted in it being prescribed again leading to a fatal outcome.
Parsonage-Turner Syndrome Following AstraZeneca COVID-19 Vaccination
Parsonage-Turner Syndrome is an uncommon cause of shoulder pain.
Herein we present the case of a male in his 40s who was presented with a 3-month history of acute onset of intense shoulder pain which decreased rapidly leaving behind a residual upper limb weakness. The diagnosis of Parsonage-Turner Syndrome following COVID-19 vaccination was made based on electroneuromyography and magnetic resonance imaging findings. The patient responded well to analgesics and rehabilitation.
A better knowledge of this disease and early recognition are crucial to prevent unnecessary tests and interventions.
Facial Hyperpigmentation Following Adalimumab
Tumor necrosis factor alpha (TNF-α) inhibitors such as adalimumab have significantly advanced the treatment of inflammatory diseases. However these therapies are associated with various cutaneous adverse reactions.
We describe two rare instances of isolated facial hyperpigmentation induced by adalimumab. Both patients presented with asymptomatic isolated brown macules on the cheeks following adalimumab treatment for ankylosing spondylitis. The hyperpigmentation appeared shortly after starting the medication in both cases. In one case the hyperpigmentation persisted despite stopping the medication while in the second case it completely resolved within one month after discontinuation. However in the second patient the hyperpigmentation recurred after switching to certolizumab another TNF-α inhibitor. No skin biopsies were performed and both patients were otherwise healthy with normal laboratory evaluations.
Hyperpigmentation is an uncommon adverse reaction of this class of drugs with only a few reported cases in the literature. The recurrence of hyperpigmentation after switching to another TNF-α agent certolizumab further suggests that this reaction may be a class effect adding new insights into the spectrum of cutaneous side effects associated with TNF-α inhibitors. Clinicians should consider this potential side effect in patients presenting with hyperpigmentation and sun protection should be recommended as a preventive measure.
DRESS Mimicking Flushing Syndrome Associated with Vancomycin: A Case Report
The Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a serious adverse reaction that occurs weeks after the onset of drug exposure. DRESS syndrome is commonly associated with antiseizure drugs sulfa drugs and antibiotics.
This was a case report of a 20-year-old female who suffered from DRESS due to vancomycin with symptoms similar to the Redman syndrome. The patient was a case of Infective endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin was intravenously administered. On the 18th day during the administration of vancomycin the patient developed sudden severe flushing over the face and trunk. The offending drug was suspended and treated with antihistamines in view of Redman syndrome. Later the patient developed uncontrolled fever desquamating rash all over the body severe pruritis and eosinophilia. On applying the RegiScar score a probable case of DRESS was diagnosed. The patient was managed symptomatically and discharged.
The clinical presentation of DRESS includes skin rash fever eosinophilia and organ involvement. But in this case there was a varied initial presentation of DRESS with severe flushing which mimics the Redman syndrome due to vancomycin. Difficulty in establishing organ involvement remained a challenge in diagnosing DRESS.
DRESS can have a varied clinical presentation. Careful monitoring of all vital parameters is important in preventing the misdiagnosis of DRESS syndrome.
Diuretics-Induced Acute Pancreatitis: Case Series with a Review of the Literature
Although diuretic-induced Acute Pancreatitis (AP) cases are typically mild to moderate severe and potentially fatal occurrences can arise.
We have herein presented a series of diuretic-induced AP cases from March 2018 to February 2024 of a 54-year-old woman treated with chlorthalidone a 45-year-old male treated with hydrochlorothiazide and a 48-year-old male treated with frusemide. The literature search has identified 26 cases published to date 10 from frusemide and 16 from thiazide diuretics. The Naranjo adverse reaction probability scale has categorized all three drugs as “probable”. All cases have responded to conservative treatment and cessation of the offending drug. Various mechanisms such as hypersensitization ischemia direct cytotoxic effects hypercalcemia and dose-dependent idiosyncrasy have been found to lead to intrapancreatic activation of pancreatic enzymes resulting in drug-induced AP.
Further research into the mechanisms and genetic factors contributing to diuretic-induced AP is essential for enabling early diagnosis and management of diuretic-induced AP.
A Study on Oxygen Vacancy Resistance Mechanism of V2O5
Due to its magnetic and semiconductor properties V2O5 has shown tremendous potential in resistive switching memory.
This paper investigates the resistive mechanism of oxygen vacancies in V2O5. The formation energies of different oxygen vacancies are calculated.
The results show that oxygen vacancies tend to form single-component conductive filaments. In mixed oxygen vacancies clusters the charge transfer characteristics and density of states of the V2O5-VO13 vacancies are the most significant which is consistent with the analysis of formation energy data.
The charge transfer of cluster oxygen vacancies was calculated showing that V atoms directly connected to oxygen vacancies tend to lose electrons while adjacent oxygen atoms are more likely to gain electrons. In V2O5-VO12 and V2O5-VO13 the number of electrons obtained by O2 and O16 exceeds the average by 36.4% and 33.2%. Thus the formation of oxygen vacancies effectively improves the resistance characteristics of the V2O5.