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A Prairie Home Companion
No full textGarrison Keillor - A Prairie Home Companionhttps://commons.und.edu/performing-arts-photos/1168/thumbnail.jp
Angiotensin Receptor/Neprilysin Inhibitors as First-Line Medication to Increase Lifespan in Patients with Preserved Ejection Fraction Heart Failure
Get PDFHeart failure (HF) impacts approximately 6.7 million adults in the United States, with over half classified as heart failure with preserved ejection fraction (HFpEF). As the condition progresses, it can significantly diminish the quality of life and substantially increase the risk of early mortality. This literature review evaluates the effectiveness of angiotensin receptorneprilysin inhibitors (ARNIs) compared to traditional renin-angiotensin system (RAAS) medications in reducing hospitalizations, cardiac deaths, and natriuretic peptide levels in HFpEF patients. A comprehensive search of PubMed and Embase identified 1,033 studies, with eight meeting criteria for final analysis. Sacubitril/valsartan did not significantly reduce hospitalizations or cardiac deaths compared to RAAS therapy but did lower serum biomarkers associated with cardiac fibrosis. These findings highlight the need to tailor HF treatment based on ejection fraction and disease progression. Further large, multi-center studies are necessary to identify sub-populations that may benefit most from ARNI therapy
Efficacy of Low-dose Naltrexone Compared to Gabapentinoids in Fibromyalgia
Get PDFFibromyalgia is a chronic pain disorder and often a diagnosis of exclusion characterized by widespread non-specific pain, fatigue, and cognitive dysfunction. Despite fibromyalgia’s significant prevalence, optimal clinical management remains uncertain because of its uncertain pathophysiology. This literature review evaluates the efficacy, safety, and tolerability of low-dose naltrexone (LDN) compared to gabapentinoids, including gabapentin and pregabalin, in the management of fibromyalgia symptoms. A literature review of studies published between 2005 and 2024 was conducted using PubMed\u27s electronic search base. Specific keywords included LDN, low-dose-naltrexone, fibromyalgia, pregabalin, and gabapentin. Specific criteria were set to include all clinical trials and randomized controlled trials and articles including duloxetine, neuropathy, adolescence, and depression were specifically excluded. Pilot studies on LDN highlighted its potential anti-inflammatory benefits and its ability to reduce pain severity and improve quality of life, with minimal side effects reported. Conversely, gabapentinoids demonstrated a dose-dependent efficacy in pain reduction and improved sleep quality. However, they were also associated with notable adverse effects, including dizziness and sedation, which may limit their tolerability. Both treatments showed limited efficacy in addressing fatigue and depressive symptoms. The findings underscore the need for more extensive, long-term research to confirm the therapeutic potential of LDN and refine the clinical use of gabapentinoids in fibromyalgia management
Mitakuye Oyasin
No full textA 3D paper piece with a rider on a horse in front of a large sun on ledger paper. There is a bison above and below the central figure.https://commons.und.edu/native-art/1136/thumbnail.jp
Efficacy of GLP-1 Receptor Agonists in Women with Polycystic Ovary Syndrome
Get PDFPolycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive aged women and is characterized by irregular menstrual cycles, hyperandrogenism, and obesity (Brady et al., 2023). The purpose of this literature review is to compare glucagon-like-peptide-1 receptor agonists (GLP-1 RAs) to the typical treatment, metformin, in improving outcomes such as weight loss, insulin resistance, hyperandrogenism, and menstrual regularity in obese women with PCOS. Electronic databases including PubMed, Embase, and ScienceDirect were searched from April to July 2024 using a variety of keywords and MeSH terms. This review included studies from 2014-2024, randomized control trials, pilot studies, and clinical trials. A total of 10 studies met final inclusion criteria. Current literature at the time of this review suggests that GLP-1 RAs contribute to increased weight loss when combined with metformin. The combination therapy also improves markers of hyperandrogenism in women with PCOS such as luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone. A larger research study with diverse populations and strict lifestyle modification monitoring is needed to generalize recommendations on GLP-1 RAs in addition to metformin for obese women with PCOS
Impact of Altering Gut Microbiota with Multinutrient Supplementation on Neuropsychiatric Symptoms in Attention Deficit/Hyperactivity Disorder
Get PDFAttention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neuropsychiatric condition affecting children, often characterized by inattention, hyperactivity, and impulsivity. Recent evidence suggests a potential link between gut microbiota composition and neuropsychiatric disorders, including ADHD, through the gut-brain axis (GBA). A literature review of studies published between 2017 and 2024 explores the efficacy of multinutrient interventions on influencing gut microbiota to treat the core symptoms of ADHD in children ages 6-12 years old. Findings indicate that multinutrient supplementation may modulate gut microbiota and subsequently impact neuropsychiatric symptoms, offering a promising adjunctive treatment for ADHD. However, variability in study methodologies and small sample sizes highlight the need for further research to establish conclusive evidence and practical clinical applications
Analysis of Pre-procedural Intranasal Anxiolytic Use in the Emergency Treatment of Pediatric Laceration Repair
Get PDFPediatric laceration repair is a common, yet anxiety-inducing procedure for patients who must undergo them, with limited research analyzing the different types of pre-procedural anxiolytic medications. The purpose of this research and literature review was to analyze two different, but commonly used intranasal anxiolytics, dexmedetomidine and midazolam, and to compare the efficacy, adverse effects, and overall pediatric anxiety and parental satisfaction. Only articles including clinical trials and pediatric participants were included. A combination of keywords and MeSH phrases included, but were not limited to “pediatric”, “laceration repair”, “anxiolytic”, “administration intranasal”, “intranasal midazolam”, “intranasal dexmedetomidine”, and “parent satisfaction” were used to find relevant articles for each theme. Meta-analyses, animal studies, dental procedures, imaging procedures, full sedation procedures, and ongoing studies were excluded. In terms of effective anxiolysis, intranasal dexmedetomidine at a 2 or 3 ug/kg dose should be considered the preferred intranasal medication for pediatric laceration repair procedures as it significantly reduced anxiety levels during laceration repair and increased parental satisfaction scores without having any reported significant adverse effects. Counteractively, intranasal midazolam, when administered at a dose of 0.4 mg/kg 5mg/mL solution also revealed a decrease in pediatric anxiety, but also imposed vomiting adverse effects. Therefore, intranasal dexmedetomidine (IND) is preferred. Future studies regarding IND’s bioavailability, pharmacokinetics, and optimal doses per age or weight groups could be considered in the future for further supportive evidence
Pharmacological Treatment Options for Nonalcoholic Steatohepatitis: Resmetirom vs GLP- 1 Receptor Agonists
Get PDFThe incidence of nonalcoholic steatohepatitis (NASH) is continually rising and has now emerged as one of the leading causes of cirrhosis requiring liver transplantation (Maurice et al., 2018). Until recently, the management of this disease has been limited to lifestyle modification and treatment of comorbid risk factors. In March 2024, the FDA approved resmetirom, the first and only medication for the treatment of this condition. The purpose of this literature review is to investigate the efficacy of GLP-1 and dual GLP/GIP or GLP/GCGR receptor agonist medications for the reduction of liver fat content in comparison to resmetirom. A literature review was conducted using electronic databases PubMed and Embase from April to July 2024. Keywords and MeSH terms were used to narrow the literature to studies investigating the use of resmetirom, GLP-1, and dual GLP/GIP/GCGR medications for hepatic fat reduction in participants with nonalcoholic steatohepatitis. Keywords included nonalcoholic steatohepatitis, NASH, nonalcoholic fatty liver disease, NAFLD, resmetirom, glucagon-like peptide 1 receptor agonist, and GLP-1. A database search returned 698 articles. Results were narrowed to 44 articles after the application of filters for randomized controlled trials and publication dates no older than 2014. The remaining articles were manually filtered to yield 11 studies that met the final inclusion criteria. Data reported from the articles included in this review suggests that resmetirom is superior to GLP-1 medications for the improvement of fibrosis in participants with a higher classification of fibrosis, but both medications appear to be equivocal for liver fat reduction in those with lower fibrosis stages and in those with nonalcoholic fatty liver disease, the less severe form of NASH