The role of proprotein convertase subtilisin/kexin type 9 inhibitors in managing cardiovascular risk

Hypercholesterolaemia and dyslipidaemia, marked by decreased levels of high-density lipoprotein and elevated levels of lowdensity lipoprotein (LDL), increase the risk of cardiovascular disease. Familial hypercholesterolaemia (FH), diagnosed based on the clinical features seen in patients with a positive family history, constitutes a heritable disorder involving a single gene. FH can exist in either the heterozygous or homozygous form, and may be differentiated based on clinical features and genetic studies. A novel drug target, proprotein convertase subtilisin/kexin type 9 (PCSK9), has resulted in the development and subsequent approval of new, targeted monoclonal antibodies in the treatment of FH. Targeting PCSK9 with monoclonal antibodies, i.e. evolocumab and alirocumab, inhibits the degradation of LDL receptors, and against a background of optimised statin therapy, increases the life expectancy of patients with hypercholesterolaemia by reducing the incidence and severity of coronary artery disease.Keywords: alirocumab, evolocumab, cardiovascular risk factors, familial hypercholesterolaemia, PCSK9, proprotein convertase subtilisin/kexin type 9, LDL cholesterol, LDL recepto

Shifting the paradigm in the management of conditions affecting the thyroid gland

Disorders of the thyroid gland are frequently encountered in the clinical practice setting and typically fall into one of two categories, namely hypothyroidism (i.e. deficient levels of circulating thyroid hormone), or hyperthyroidism (or thyrotoxicosis) that involves abnormally high levels of thyroid hormone in the bloodstream. This article provides a high-level overview of thyroid function, the two major pathophysiological abnormalities of the thyroid gland, as well as treatment modalities aimed at managing patients with thyroid pathology

Pharmacotherapy during pregnancy, childbirth and lactation: points and principles to consider (a 2015 update)

Pregnancy, childbirth and lactation pose unique challenges in terms of drug therapy. The pregnant mother and her unborn child are exceptionally vulnerable from a physiological, clinical and ethical standpoint. This warrants careful consideration with respect to a number of important aspects, which could firstly influence the decision to opt for drug therapy, and secondly, could influence the specific agent selected for each indication. The US Food and Drug Administration has introduced changes to the content and format of information presented in prescription drug labelling to assist healthcare providers when assessing benefit versus risk, and in the subsequent counselling of pregnant woman and nursing mothers who need to take medication. This change came into effect at the end of June 2015. This article provides an overview of these important aspects.Keywords: embryo, foetus, lactation, neonate, pregnanc

The allergic scholar

Allergic diseases are on the increase globally. There has been a doubling in the number of scholars suffering from allergy-related disease in the past two decades. This article describes the predisposing factors which contribute to an increased incidence of allergies within the population. These factors include a genetic  predisposition, allergen exposure, abnormalities in the bowel flora and infection exposure. Some of these  relate to the hygiene hypothesis and the microflora hypothesis, which are discussed in this article. Treatment options for those suffering from allergic disease are also discussed, with an emphasis on asthma, anaphylaxis, allergic rhinitis and atopic dermatitis.Keywords: atopy, allergy, scholars, corticosteroids, antihistamine

Gastro-oesophageal reflux: An overview of the cost-effectiveness of pharmacotherapeutic treatment options

Gastro-oesophageal reflux disease (GORD) produces symptoms that cause great irritation to the patient. Pharmacotherapeutic management is directed at minimising these symptoms and reducing the causative factors, e.g. acid production, thereby providing relieve. Currently available agents include simple antacids and acid suppression therapy, including histamine 2-receptor antagonists, proton pump inhibitors, mucosal or cytoprotective agents, pro-motility agents. Deciding on appropriate therapy will be dependent on the diagnosis, side-effects and cost-effectiveness of the treatment.Keywords: GORD, gastro-oesophageal reflux, PPIs, proton-pump inhibitors, cost effectivenes

Clinical overview of venous thromboembolism

Venous thromboembolism (VTE) encompasses two vascular conditions that are of significant importance, namely deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is also the most common cause of PE. Medical and surgical patients, and individuals who are at increased risk of developing VTE through a variety of factors, require adequate thromboprophylaxis. Primary and secondary prevention, as well as the definitive treatment of VTE, are accomplished through the use of a variety of anticoagulant drugs. This article attempts to provide an overview of VTE, and its prevention and treatment.Keywords: anticoagulants, deep vein thrombosis, DVT, embolus, NOAC, PE, pulmonary embolism, thromboprophylaxis, thrombus, venous thromboembolism, Virchow’s triad, VT

An update on chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is a chronic condition which affects the respiratory system and worsens over time. Cigarette smoking and advancing age are the two major risks associated with this disease. It is concerning that the global incidence of this chronic illness is on the rise. Current projections indicate that it will become the third leading cause of death by the year 2020. Inflammatory changes underlie the pathophysiology of COPD. Irreversible damage and progressive narrowing of the air passages follow. COPD is characterised by the progressive loss of lung function. In addition, the Global Initiative for Chronic Obstructive Lung Disease released the latest update on its global strategy for the diagnosis, management, and prevention of COPD in 2015. This article provides an overview of the causative risk factors, underlying disease process, pathophysiological changes, and the classification and management of COPD, including the latest perspectives on this highly prevalent condition.Keywords: chronic bronchitis, chronic obstructive pulmonary disease, COPD, emphysema, LABA, SABA, SAMA, LAMA, methylxanthine

Optimizing the Purification Process for Microwave Synthesized Lead Halide Perovskites

Lead halide perovskite nanocrystals (LHPs) have become a promising optoelectronic material due to their bright photoluminescence, low manufacturing cost, and application in solar cells and light emitting diodes (LEDs). Quantum yield (QY) is a metric used to quantify the efficiency by which they emit light, defined as the ratio of number of photons emitted to those absorbed. Currently there are several commonly used routes for synthesizing LHPs, including the hot injection (HI) and room temperature supersaturated recrystallization (SR) methods. Each technique presents its own challenges in the form of high operating temperatures, low stability of resulting LHPs, or lack of precise control over the synthesis process. Developments have been made toward a new synthesis technique, using a microwave reactor to produce highly stable and luminescent perovskites. This microwave synthesis allows for the precise control of operating parameters while being simpler than traditional methods since it is a one-pot technique. In order to fully optimize a microwave synthesis for LHPs, work must be done to improve the purification procedure. Purification is a necessary step in the synthesis of LHPs as it allows for better analysis of optical properties and can even improve QY. Herein, we attempt to further optimize perovskites produced via microwave synthesis by comparing different purification techniques to determine which produces the most luminescent QDs.https://orb.binghamton.edu/research_days_posters_2021/1067/thumbnail.jp

An overview of anti-allergic drug therapy and the histamine-1 antihistamines

Allergic disease decreases the daily quality of life of many people, and can increase the number of working days lost owing to sick leave. Associated symptoms with allergic disease depend on the origin of the disease, and can either be allergic, non-allergic and purulent, or can cause rhinitis as a result of a common cold. Treatment depends on the origin of the rhinitis. However, an antihistamine is indicated in most instances. Combination treatment includes sympathomimetic drugs (either local or systemic) and corticosteroid medication (when indicated, and in most instances, used locally). The article provides an overview of the nature and the management of allergic disease and the histamine 1 antihistamines.Keywords: anti-allergic drug therapy, H1 antihistamines, histamine receptors, allergic rhinoconjunctivitis, allergy healt

Cardiovascular effects and the use of nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) include the nonselective and the cyclo-oxygenase-2-specific inhibitors. These agents are used for pain associated with musculoskeletal conditions. The nonselective   anti-inflammatory drugs are still widely used, and are also freely available as over-the-counter analgesics. However, they carry the risk of serious  cardiovascular adverse effects, especially in patients who have a high,  pre-existing cardiovascular risk profile. It is imperative that physicians are aware of these risk factors and choose agents that have the best benefit-to-risk profile, while taking into consideration the patient’s individual risk profile