N-Heterocycles as Promising Antiviral Agents: A Comprehensive Overview.

Viruses are a real threat to every organism at any stage of life leading to extensive infections and casualties. N-heterocycles can affect the viral life cycle at many points, including viral entrance into host cells, viral genome replication, and the production of novel viral species. Certain N-heterocycles can also stimulate the host's immune system, producing antiviral cytokines and chemokines that can stop the reproduction of viruses. This review focused on recent five- or six-membered synthetic N-heterocyclic molecules showing antiviral activity through SAR analyses. The review will assist in identifying robust scaffolds that might be utilized to create effective antiviral drugs with either no or few side effects.

Influence of Clinical Factors on the Quality of Life in Romanian People with Epilepsy-A Follow-Up Study in Real-Life Clinical Practice.

BACKGROUND: This study aimed to assess the influence of various clinical factors on the quality of life perception of patients with epilepsy over a follow-up period in current clinical practice. METHODS: Thirty-five PWE evaluated via video-electro-encephalography in the Clinical Hospital of Psychiatry and Neurology in Brasov, Romania, were included, and the quality of life was assessed using the Romanian version of the QOLIE-31-P questionnaire. RESULTS: At baseline, the mean age was 40.03 (±14.63) years; the mean duration of epilepsy was 11.46 (±12.90) years; the mean age at the first seizure was 28.57 (±18.72); and the mean duration between evaluations was 23.46 (±7.54) months. The mean (SD) QOLIE-31-P total score at the initial visit (68.54 ±15.89) was lower than the mean (SD) QOLIE-31-P total score at the follow-up (74.15 ± 17.09). Patients with epileptiform activity recorded via video-electro-encephalography, using polytherapy, those with uncontrolled seizures, and those with one or more seizures per month had statistically significantly lower QOLIE-31-P total scores at baseline and follow-up. Multiple linear regression analyses revealed seizure frequency as a significant inverse predictor of quality of life in both evaluations. CONCLUSIONS: The QOLIE-31-P total score was improved during the follow-up period, and medical professionals should use instruments to evaluate quality of life and identify patterns while trying to improve the outcomes of patients with epilepsy.

Impact of Clinical and Socio-Demographic Factors on the Quality of Life in Romanian People with Epilepsy.

This study investigates the impact of different clinical and demographic factors on the quality of life in people with epilepsy hospitalized at a health institution of Brasov County, Romania, using a QOLIE-31-P questionnaire and to reflect on the opportunities and limitations of incorporating such an instrument into the clinical practice. Methods: Ninety-one patients with a diagnosis of epilepsy evaluated by video-electroencephalography in the Clinical Hospital of Psychiatry and Neurology in Brasov, Romania, were recruited. After the confirmation of the diagnosis based on clinical, electrophysiological and imagistic examination, and of their compliance with the hospitalization criteria, the patients filled in the QOLIE-31-P questionnaire. Socio-demographic and clinical data were collected. Results: The seizure frequency was negatively correlated with almost all QOLIE-31-P domains (p < 0.05). Age, employment status, level of education and uncontrolled disease were significant factors associated with a low quality of life. The mean (SD) QOLIE-31-P scores were 64.89 (14.72), the mean age was 43.04 (14.92) years, with the average age of the first seizure onset 30.66 (17.45) years. Conclusion: The use of measuring instruments to assess the quality of life of patients with epilepsy despite the challenges should become a routine practice, the information collected in this way can improve the outcomes in the care of these patients. In addition to the goal of reducing the frequency of seizures, physicians must also take into account other parts of the experiences of people with epilepsy.

Achyranthes aspera Extracts as Adjuvants for the Redressal of Antibiotic Resistance.

Achyranthes aspera seeds and leaves are believed to reverse antibiotic resistance and increase the efficacy of current drugs. Achyranthes aspera seeds and leaves contain many secondary metabolites needed for the redressal of antibiotic resistance. In the present study, seven different antibiotics were used against five different strains of bacteria such as Methicillin-resistant Staphylococcus aureus, Enterococcus faecalis, Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. For Methicillin-resistant Staphylococcus aureus Cefoxitin, Penicillin, and Co-trimoxazole were resistant out of seven antibiotics. The zone of inhibition for all these three antibiotics goes from the resistant to the sensitive range after the combination with plant extracts. For Enterococcus faecalis, Ciprofloxacin, Levofloxacin, Penicillin, Amoxicillin, Imipenem, and Vancomycin were resistant after treatment with the plant extracts, and the Ciprofloxacin, Levofloxacin, Imipenem, and Vancomycin zones of inhibition were from the resistant to the sensitive range. An increase in zone sizes was observed for Penicillin, but it remained resistant while no zone of inhibition was observed for Amoxicillin. For Acinetobacter baumannii, Ciprofloxacin, Levofloxacin, Ceftriaxone, Ceftazidime, and Imipenem were resistant. After a combination of these antibiotics with plant extracts, a change in zone sizes was observed for Levofloxacin and Ceftriaxone, but it was not considerable as it remained in the resistance and intermediate ranges. No zones of inhibition were observed for Ciprofloxacin, Ceftazidime, or Imipenem. For Klebsiella pneumoniae, all the antibiotics were resistant. An increase in zone sizes was observed after a combination with plant extracts for Ceftazidime and Imipenem in Klebsiella pneumoniae, but it remained in the resistance category. No zone of inhibition was observed for Pseudomonas aeruginosa before or after using plant extracts against any antibiotic. This study suggests that the Achyranthes aspera seed and leaf extracts can reverse antibiotic resistance without any side effects on the human body, and that they can reverse antibiotic resistance naturally.

Thrombosis, an important piece in the COVID-19 puzzle: From pathophysiology to therapy.

A lot of data about coronavirus disease 2019 (COVID-19) have been already published; however, these still form only a part of the pandemic puzzle. Once we have all the pieces of the puzzle, we will be able to successfully treat this disease with its multiple challenges. COVID-19 has a high thrombogenic potential. In this study, we aimed to review published data about COVID-19 associated thrombosis from pathophysiology to treatment and the role in patient evolution. We searched for articles and studies published online through MEDLINE/PubMed database, Google Scholar, ScienceDirect, Wiley Online Library, and Nature Public Health Emergency Collection. We found numerous articles regarding COVID-19 infection but selected only those focused on thrombosis. D-dimers have a predictive value in identifying thrombosis and a high level correlates with the severity of the infection and death. Most patients who were on chronic anticoagulant therapy before contracting the virus had a better prognosis. Heparin has other favorable effects such as a direct antiviral and anti-inflammatory effect in addition to its anticoagulant effect. COVID-19 infections are frequently complicated by thrombotic pathology. High plasma level of D-dimers is a predictive factor for severe prognosis, and the recommended anticoagulant, associated with low mortality, is heparin followed by a direct oral anticoagulant. Randomized studies in large groups of patients and therapeutic guidelines are still needed on this subject.

A Comprehensive Review of the Ethnotraditional Uses and Biological and Pharmacological Potential of the Genus Mimosa.

The Mimosa genus belongs to the Fabaceae family of legumes and consists of about 400 species distributed all over the world. The growth forms of plants belonging to the Mimosa genus range from herbs to trees. Several species of this genus play important roles in folk medicine. In this review, we aimed to present the current knowledge of the ethnogeographical distribution, ethnotraditional uses, nutritional values, pharmaceutical potential, and toxicity of the genus Mimosa to facilitate the exploitation of its therapeutic potential for the treatment of human ailments. The present paper consists of a systematic overview of the scientific literature relating to the genus Mimosa published between 1931 and 2020, which was achieved by consulting various databases (Science Direct, Francis and Taylor, Scopus, Google Scholar, PubMed, SciELO, Web of Science, SciFinder, Wiley, Springer, Google, The Plant Database). More than 160 research articles were included in this review regarding the Mimosa genus. Mimosa species are nutritionally very important and several species are used as feed for different varieties of chickens. Studies regarding their biological potential have shown that species of the Mimosa genus have promising pharmacological properties, including antimicrobial, antioxidant, anticancer, antidiabetic, wound-healing, hypolipidemic, anti-inflammatory, hepatoprotective, antinociceptive, antiepileptic, neuropharmacological, toxicological, antiallergic, antihyperurisemic, larvicidal, antiparasitic, molluscicidal, antimutagenic, genotoxic, teratogenic, antispasmolytic, antiviral, and antivenom activities. The findings regarding the genus Mimosa suggest that this genus could be the future of the medicinal industry for the treatment of various diseases, although in the future more research should be carried out to explore its ethnopharmacological, toxicological, and nutritional attributes.

Trimetazidine Therapy in Coronary Artery Disease: The Impact on Oxidative Stress, Inflammation, Endothelial Dysfunction, and Long-Term Prognosis.

BACKGROUND: In coronary artery disease (CAD), reduction of perfusion in coronary arteries is followed by increases of oxidative stress and decreases of adenosine triphosphate reserve. In this condition, trimetazidine (TMZ), a metabolic anti-ischemic agent, seems to be an ideal therapeutic agent because it increases mitochondrial adenosine triphosphate production. STUDY QUESTION: To evaluate the impact of TMZ on oxidative stress, inflammation, endothelial dysfunction, and long-term prognosis in CAD. STUDY DESIGN: Patients with CAD with symptoms not adequately controlled were enrolled consecutively for a period of 18 months. MEASURES AND OUTCOMES: Five hundred seventy patients with CAD were enrolled in a prospective study and divided into 4 groups in relation with the type of CAD and the addition of TMZ to optimal medical therapy (OMT). The impact of TMZ added to OMT on oxidative stress (total antioxidant status, antioxidized low-density lipoprotein antibodies, and antimyeloperoxidase antibodies), endothelial dysfunction (flow-mediated dilatation and von Willebrand factor activity), and inflammation (C-reactive protein and fibrinogen) at 6 months and on long-term prognosis in CAD in comparison with OMT at 5 years of follow-up was evaluated. RESULTS: At 6 months, TMZ added to OMT significantly decreased the incidence of oxidative stress in CAD (P < 0.03) and reduced endothelial dysfunction and inflammation only in non-ST-elevation acute coronary syndrome (NSTE-ACS, P < 0.04). TMZ added to OMT with or without interventional/surgical vascularization led to decreased readmission for NSTE-ACS and heart failure (P < 0.05) in all patients with CAD and a significantly reduced incidence of cardiovascular death, acute myocardial infarction, and stroke (P < 0.05) in patients with NSTE-ACS at 5 years of follow-up. CONCLUSIONS: In patients with NSTE-ACS, TMZ added to OMT with or without interventional and/or surgical reperfusion reduced oxidative stress, endothelial dysfunction, inflammation, and major acute cardiovascular events, whereas in patients with chronic coronary syndrome, TMZ decreased oxidative stress and readmission for ACS and heart failure.

Risk management strategies and therapeutic modalities to tackle COVID-19/SARS-CoV-2.

The recent emergence of novel coronavirus disease (COVID-19) triggered by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has resulted in substantial mortality worldwide. Presently, there is no approved treatment for COVID-19. Consequently, the clinical, scientific, and regulatory authorities have joint efforts to reduce the severe impact of COVID-19. To date, there is minimal arsenal with no definite curative drugs, licensed-vaccines, or therapeutic conducts to combat the COVID-19 infections. Keeping in view the threats of this pandemic, various global organizations, physicians, researchers, and scientists, are trying to recognize the epidemiological characteristics and pathogenic mechanisms of COVID-19 to discover potential treatment regimens, vaccines, and therapeutic modes for future anticipation. Herein, we summarize a contemporary overview of curative invasions and vaccines for COVID-19 based on the earlier information and considerate of similar earlier RNA coronaviruses. The information reviewed here establishes a paramount intellectual basis to promote ongoing research to develop vaccines and curative agents. Thus, this review suggests the furthermost accessible frontiers in the vaccine development to tackle or combat the COVID-19/SARS-CoV-2.

Challenges in the Prevention of Cervical Cancer in Romania.

Approximately every two hours, a Romanian woman is diagnosed with cervical cancer as the country ranks first in the EU in terms of its mortality rate. This paper aims to identify the main reasons that have led to this situation. First, a study based on secondary data was conducted in order to identify measures taken by the Romanian Ministry of Health for the prevention of this type of cancer. Second, a quantitative study was conducted to evaluate the impact that exposure to information and awareness campaigns has on women's behavior regarding cervical cancer prevention through screening. The results of the research show an increased percentage of the women understanding the importance of screening and the benefits of early diagnosis, but also shows that a high percentage of women postpone the routine checks due to lack of time and financial resources. The research results also indicate that the only free screening program implemented in Romania during 2012-2017 was a failure due to poor procedures, low number of women tested, underfunding and the lack of promotion. Our conclusion is that the Romanian Ministry of Health has to take immediate action by conducting major awareness campaigns and also by implementing functional screening programs.

Low Response to Clopidogrel in Coronary Artery Disease.

BACKGROUND: In patients with coronary artery disease, cardiovascular mortality and other acute events showed a clear correlation with risk factors and biomarkers including platelet activation. STUDY QUESTION OF THIS RESEARCH: Which was the incidence of low response to clopidogrel and its correlation with risk factors and biomarkers in coronary artery disease? STUDY DESIGN: Four hundred patients (pts) with coronary artery disease-stable angina (SA) and acute coronary syndrome-were divided into 8 groups of study, consistent with low response to clopidogrel and the type of coronary artery disease. Low response to clopidogrel-defined as adenosine diphosphate test-ADP-test of >46 U by multiple electrode platelet aggregometry was evaluated in correlation with cardiovascular risk factors and biomarkers of oxidative stress, endothelial dysfunction, hypercoagulability, high platelet reactivity. RESULTS: In coronary artery disease, low response to clopidogrel significantly correlated with older than 65 years, smoking, hypertension, diabetes mellitus, body mass index of >25, previous aspirin treatment (P < 0.05), high value of total and low-density lipoprotein cholesterol, low value of high-density lipoprotein cholesterol, low response to aspirin, high mean platelets volume and von Willebrand factor activity, low flow-mediated vasodilatation, total antioxidant status (P < 0.01) and only in patients with SA of male gender (P < 0.01). The incidence of other hypercoagulability biomarkers, such as reduced values of S protein, C protein, antithrombin III, and V Factor Leiden resistance to activated protein C, was very low and not correlated with low response to clopidogrel. CONCLUSIONS: In coronary artery disease, low response to clopidogrel significantly correlated with the most of old cardiovascular risk factors, with previous aspirin treatment, low response to aspirin, higher mean platelets volume, higher von Willebrand factor activity, lower flow-mediated vasodilatation, and lower total antioxidant status values and only in patients with SA of male gender.