Saturday 29 September 2018

Atherosclerosis


Atherosclerosis: Mechanisms, current therapies and the potential of natural products in the prevention and treatment of the disease


Atherosclerosis, a chronic inflammatory disorder of medium and large arteries and the underlying cause of heart attacks and stroke, is responsible for more global deaths than any other disease. A slight reduction in morbidity and mortality from atherosclerosis and its complications has been seen recently, at least in the western world, due to lifestyle changes and pharmaceutical interventions (e.g. statins). However, the global burden from this disease is expected to worsen in the near future because of recent increases in risk factors such as diabetes and obesity. Current pharmaceutical treatments for atherosclerosis are associated with considerable residual risk for cardiovascular disease together with various side effects. With the exception of few successes (e.g. ezetimibe, PCSK9 inhibitors), many pharmaceutical leads against established targets have proved disappointing at the clinical level. It is therefore important that further research is carried out on the molecular basis of atherosclerosis together with alternative therapies for its prevention and treatment.

Natural products have received substantial recent interest in the prevention and treatment of atherosclerosis. However, more research is required that addresses the molecular mechanisms underlying the beneficial effects of natural products together with large clinical trials that evaluate their efficacy. We have recently initiated studies on the effects of many natural products, including certain polyunsaturated fatty acids, polyphenols and probiotics, on several key monocyte/macrophage processes associated with atherosclerosis in vitro and various risk factors in vivo together with the underlying mechanisms. These will be presented in the context of molecular mechanisms underlying atherogenesis together with current therapies and those that are being developed.


 


Wednesday 26 September 2018

Real-World Evidence: The Public Health Perspective for Chronic Diseases



Real-World Evidence: The Public Health Perspective for Chronic Diseases 

Statement of the Problem: In the last decade, Real-World Data (RWD) has been increasingly used to provide Real-World Evidence (RWE) in the arena of developing new medical products. RWE complements findings from Randomized Controlled Trials (RCT) by providing information about clinical use of the products in the broader population, and how different environmental and health-care factors can influence treatment effects and/or outcomes.  Nevertheless, the potential of RWD/RWE has not been extensively explored in the field of chronic diseases. 
Objective: The aim is to explore the use of RWD/RWE for maintenance therapies among patients with chronic diseases.
Methodology: The strengths, weaknesses, and potential extension of RWD/RDE applications were analyzed by the review of two case studies: (1) The use of antihypertensive medications and change in stages of chronic kidney disease in American adults during 1999-2012; and (2) Changes in cognitive function in American population – metabolic syndrome and use of antipsychotic medications in 1999-2016.   
Findings: The following factors can expedite the use of RWD/RWE in the field of chronic diseases: (1) setting of multiple population-oriented databases with standardized data collection and easy linkage; (2) expending of existing analytic methods and developing novel methodological approaches to conduct such research. In addition, clinical research with open access will expedite understanding of RWE studies and findings by the communities with diverse population of patients.
Conclusions and Relevance: RWD can play significant role in the area of chronic diseases. There is some work to be
done to utilize RWD/RWE for clinical research of maintenance therapies among patients with chronic diseases. 

For more details visit Chronic Diseases 2019

Chronic Fatigue Syndrome

Chronic Fatigue Syndrome   (CFS) is a chronic disease and the individual shows extreme tiredness pain and sleep disorders that persist ...