Use of anticoagulant drugs in patients with atrial fibrillation. Does adherence to therapy have a prognostic impact?

Anticoagulant therapy represents a pivotal element that strongly influences the thromboembolic risk of non-valvular atrial fibrillation (NVAF) subjects. The main purpose of this review was to identify issues and suggest strategies to improve the oral anticoagulants (OACs) treatment adherence, which is the most important predictor of NVAF outcome. Advantages, efficacy, and impact of these drugs on patients' prognosis were revealed in important clinical trials on large cohorts of patients and are often prescribed nowadays. A real-life data registry, the Global Anticoagulant Registry in the Field-Atrial Fibrillation (GARFIELD-AF) analyzed the profile and outcome of patients diagnosed with NVAF receiving oral antithrombotic treatment. The observations gathered in the registry were crucial for identifying relevant elements that clinicians must improve, such as adherence strategies and predisposing factors that correlated with stroke. Adherence to OACs in AF patients is essential from the viewpoint of clinical efficacy and safety. Major adverse events and negative outcome are correlated with a weak anticoagulation control caused by an ineffective treatment adherence strategy. Solving the issue of oral anticoagulation adherence is possible using new technologies, but future directions should be explored. Mobile phone applications centered on patients' needs, telemedicine programs that evaluate patients' evolution and detect adverse reactions or events, encouraging an adequate management of the event without interruption of OACs, represent perspectives with a major impact on treatment adherence.

Non-conventional therapeutical approaches to acne vulgaris related to its association with metabolic disorders

The ever-increasing frequency of metabolic syndrome (MetS) is still a major challenge of the public health care system, worldwide. In recent years, researchers have been drawn to the uncommon (at first look) link between skin illnesses and MetS. Because of the pro-inflammatory mechanisms and insulin resistance (IR) that are upregulated in metabolic syndrome, many skin disorders are correlated to metabolic dysfunctions, including acne vulgaris. A comprehensive understanding of the link between MetS and acne vulgaris may contribute to the development of new treatment strategies. The current review focuses on dietary and therapeutic interventions and assesses the effect of various approaches such as improving diet by avoiding certain food products (i.e., milk and chocolate) or increasing the intake of others (i.e., food products rich in omega-3 fatty acids), metformin administration, therapy with plant extracts, plant essential oils, and probiotic supplementation on the improvement of certain acne vulgaris severity parameters. These therapeutic approaches, when combined with allopathic treatment, can improve the patients' quality of life.

A Narrative Review of the Classical and Modern Diagnostic Methods of the No-Reflow Phenomenon

The incidence of the no-reflow (NR) phenomenon varies depending on the diagnostic criteria used. If just the angiographic criteria are considered (i.e., a degree of thrombolysis in myocardial infarction ≤2), it will be found that the incidence of NR is quite low; on the other hand, when the myocardial NR is taken into account (i.e., a decrease in the quality of myocardial reperfusion expressed by the degree of myocardial blush), the real incidence is higher. Thus, the early establishment of a diagnosis of NR and the administration of specific treatment can lead to its reversibility. Otherwise, regardless of the follow-up period, patients with NR have a poor prognosis. In the present work, we offer a comprehensive perspective on diagnostic tools for NR detection, for improving the global management of patients with arterial microvasculature damage, which is a topic of major interest in the cardiology field, due to its complexity and its link with severe clinical outcomes.

The Footprint of Kynurenine Pathway in Neurodegeneration: Janus-Faced Role in Parkinson's Disorder and Therapeutic Implications

Progressive degeneration of neurons and aggravation of dopaminergic neurons in the substantia nigra pars compacta results in the loss of dopamine in the brain of Parkinson's disease (PD) patients. Numerous therapies, exhibiting transient efficacy have been developed; however, they are mostly accompanied by side effects and limited reliability, therefore instigating the need to develop novel optimistic treatment targets. Significant therapeutic targets have been identified, namely: chaperones, protein Abelson, glucocerebrosidase-1, calcium, neuromelanin, ubiquitin-proteasome system, neuroinflammation, mitochondrial dysfunction, and the kynurenine pathway (KP). The role of KP and its metabolites and enzymes in PD, namely quinolinic acid (QUIN), kynurenic acid (KYNA), 3-hydroxykynurenine (3-HK), 3-hydroxyanthranillic acid (3-HAA), kunurenine-3-monooxygenase (KMO), etc. has been reported. The neurotoxic QUIN, N-methyl-D-aspartate (NMDA) receptor agonist, and neuroprotective KYNA-which antagonizes QUIN actions-primarily justify the Janus-faced role of KP in PD. Moreover, KP has been reported to play a biomarker role in PD detection. Therefore, the authors detail the neurotoxic, neuroprotective, and immunomodulatory neuroactive components, alongside the upstream and downstream metabolic pathways of KP, forming a basis for a therapeutic paradigm of the disease while recognizing KP as a potential biomarker in PD, thus facilitating the development of a suitable target in PD management.

Green Synthesis of Silver Nanoparticles Using Hypericum perforatum L. Extract and Evaluation of Their Antibacterial Activity

Silver nanoparticles (AgNPs) ranging in size from 1-100 nm show good application potential in many medical fields (therapies, medical devices, molecular diagnostics) due to their antimicrobial properties. The purpose of this study is to characterize from physicochemical perspective the colloidal dispersion obtained through phyto-synthesis. The existence of colloidal silver particles was visually highlighted through Thyndall effect. The bio-reduction of silver ions was analyzed through modern techniques, UV-VIS spectrophotometry and Hyperspectral Microscopy. After getting the colloidal dispersion, its antibacterial activity was proved by sowing on different plates the following types of pathogenic agents: Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa. The UV-VIS spectrum for the methanolic extract with 10% H. perforatum L. and for the silver colloidal dispersions was achieved, observing a max at 455 nm. The hyperspectral images were achieved observing the shape, conformation, and the size of the obtained particles. During the antibacterial efficacy testing on those three strains of pathological agents, in all situations, the colloidal dispersion had a promising antimicrobial effect.

Orchard management under the effects of climate change: implications for apple, plum, and almond growing

The authors analyzed certain species and varieties of fruit tree in which applied crop technology is used and also undergoes the effects of climate change. The aim is to extend productive crop varieties, resistant to disease and pests, in order to obtain superior yields. The research was conducted in orchards located in northwestern Romania (on 8.59 ha), intensively cultivated with apple, plum, and almond species. The blooming period of the species and fruit production was studied in 2009, the first year of the farm's commercial production, and then compared to figures from 2016 to see the changes that occurred. Climatic conditions were studied throughout the period of existence of the farm (2002-2016). To determine the influence of the climatic factor on the blooming and production periods, respectively, every year is considered having pre-blooming, blooming, and ripening periods. It was found that climate change influences the annual biological cycle of the trees: the vegetative rest period of the trees shortens, the tree vegetation begins earlier in the spring, and the blooming period is advanced by as much as 10 days compared to normal cultivated varieties. All these factors have direct repercussions on the quantity of production.

The Consequences of Excessive Chemicalization on Fruits Quality

Chemistry in agriculture has been considered for several decades a formula synonymous with progress and development, as chemical engineering, mechanization, irrigation, modern agro-technical processes have contributed to a substantial increase in production. At present, the use of pesticides to increase agricultural productivity is considered to be a global hazard to the environment. This study examines changes in tree tolerance for major diseases and pests, disease and pest behavior, and the changes that occur in the recommended pesticide treatment. The researches were carried out on different species of fruit trees (apple, plum, and almond), cultivated in an intensive system, in five orchards located in Bihor county. The behavior of each species, as well as the behavior of different varieties with respect to tolerance to major diseases and pests, have been observed over the last 5 years (2013-2017). In addition, pesticide residues were monitored from all crops of apple, plum and almond. During 2015-2017, from March to May, the diseases were more virulent, requiring intensive intervention with systemic and contact fungicide combinations to achieve optimal efficiency; this fact has been correlated with the increase in the number of samples containing pesticide residues. This perspective allows an ecological remodeling of current progress in orchard development, including all aspects of environmental protection and the impact on population2 s health.

HPLC Screening of Bioactives Compounds and Antioxidant Capacity of Different Hypericum Species

Our study compares the content in polyphenolic compounds and hypericin, in four species of Hypericum - H. perforatum L., H. maculatum Cr., H. hirsutum L., H. tetrapterum Fr. (syn. Hypericumacutum Mnch.) harvested from spontaneous flora in the north-western area of Transylvania, Romania. These species represent an important source of such compounds with different biological actions. After making the extracts, they were subjected to HPLC-SM analysis. The presence of rutoside in the largest amount (462.82 mg %) in the H. perforatum extract was observed, this containing most of the flavonoid heterosides. For the species H. maculatum, the presence in a much higher amount of the hyperoside (976.36 mg %) is characteristic compared to the other species. Quercetol is the best represented of the flavonoid aglycons, its concentration being the highest in H. hirsutum (659.66 mg %). The hypericin content ranges from 0.2171 g % in the H. tetrapterum extract, to 0.0314 g % in the methanol extract of H. maculatum.The highest antioxidant properties measured by FRAP method were recorded in the case of H. perforatum and H. maculatum.