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Medication adherence to obeticholic acid: a real-world experience using medication event monitoring systems.

We designed a clinical study to analyze patterns of adherence to  obeticholic acid, factors influencing the adherence and potential correlation with  treatment efficacy by using MEMS® cap in practice daily. Method: A multicenter prospective observational study of patients with primary  biliary cholangitis. Adherence will be measured by MEMS® cap, pill count, and  patient-reported outcomes during 3 months. The quality of life will be self- reported using the Chronic Liver Disease Questionnaire test, European Quality of  Life 5-Dimension Questionnaire test and Itch Severity Scale.

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Rediscovering the Therapeutic Potential of Agarwood in the Management of Chronic Inflammatory Diseases.

The inflammatory response is a central aspect of the human immune system that acts as a defense mechanism to protect the body against infections and injuries. A dysregulated inflammatory response is a major health concern, as it can disrupt homeostasis and lead to a plethora of chronic inflammatory conditions. These chronic inflammatory diseases are one of the major causes of morbidity and mortality worldwide and the need for them to be managed in the long term has become a crucial task to alleviate symptoms and improve patients' overall quality of life. Although various synthetic anti-inflammatory agents have been developed to date, these medications are associated with several adverse effects that have led to poor therapeutic outcomes. The hunt for novel alternatives to modulate underlying chronic inflammatory processes has unveiled nature to be a plentiful source. One such example is agarwood, which is a valuable resinous wood from the trees of spp. Agarwood has been widely utilized for medicinal purposes since ancient times due to its ability to relieve pain, asthmatic symptoms, and arrest vomiting. In terms of inflammation, the major constituent of agarwood, agarwood oil, has been shown to possess multiple bioactive compounds that can regulate molecular mechanisms of chronic inflammation, thereby producing a multitude of pharmacological functions for treating various inflammatory disorders. As such, agarwood oil presents great potential to be developed as a novel anti-inflammatory therapeutic to overcome the drawbacks of existing therapies and improve treatment outcomes. In this review, we have summarized the current literature on agarwood and its bioactive components and have highlighted the potential roles of agarwood oil in treating various chronic inflammatory diseases.

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Quality of Life in Women over 65 Years of Age Diagnosed with Osteoporosis.

(1) Background: Today's society is moving towards active aging, underlining the importance of understanding and improving quality of life (QoL). This QoL in women over the age of 65 years diagnosed with osteoporosis was compared with the QoL of the general population, and risk factors for osteoporosis related to QoL were identified. (2) Methods: This is an observational, descriptive, cross-sectional study with a personal interview. The study population was 704 women over 65 years of age diagnosed with osteoporosis as of 1 November 2018, based on medical records from four health centers of the eastern Valladolid urban health area. This was a random sample of 247 women stratified by health center. Information on osteoporosis risk factors, comorbidities, daily lifestyle habits, and QoL assessed with the EQ-5D was collected. QoL was modeled using sociodemographic variables, lifestyle, and clinical variables. (3) Results: Women with osteoporosis had a positive perception of their health (EQ-5D% VAS 64.9 ± 18.31). High EQ-5D QoL scores were obtained on the dimensions of mobility: 51.6% [95% CI (44.2%, 58.9%)]; self-care: 75.3% [95% CI (68.5%, 81.2%)]; activities of daily living: 71.4% [95% CI (64.4%, 77.6%)]; pain/discomfort: 25.8% [95% CI (19.8%, 32.6%)]; and anxiety/depression: 53.8% [95% CI (46.4%, 61.0%)]. (4) Conclusions: The QoL of the study group was no worse than the QoL of the general population, except for pain/discomfort and anxiety/depression. Age, highest educational level reached, inflammatory diseases, physical activity, and insomnia were independent predictors of QoL in women with osteoporosis.

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Trends and outcomes of primary, rescue, and adjunct middle meningeal artery embolization for chronic subdural hematomas.

Middle meningeal artery embolization (MMAE) is an effective minimally invasive treatment for chronic subdural hematomas (cSDH). The authors investigated outcomes of primary, adjunct, and rescue MMAE and primary surgery for the treatment of cSDH using a large-scale national database.

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Special Issue “Migraine and Headache in Children and Adolescents”.

Migraine in developmental age is a common pathology […].

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Palmitoylethanolamide-based nutraceutical Calmux® in preventive treatment of migraine.

The aim of this study was to determine the efficacy and tolerability of treatment with a Palmitoylethanolamide (PEA)-based nutraceutical in patients with episodic migraine.

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Early and Long-Term Outcomes after Propofol-and Sevoflurane-Based Anesthesia in Colorectal Cancer Surgery: A Retrospective Study.

Propofol is considered to protect against immunosuppression and has lower inflammatory responses in the perioperative period than volatile agents. We evaluated whether the anesthetic agent is associated with cancer outcomes.

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A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report.

This case report describes a modified approach for a thoracic paravertebral block by performing a bilateral ultrasound-assisted injection of 12 mL of 0.5% levobupivacaine near the thoracic intervertebral foramen, combined with general anesthesia, in a patient who underwent emergent laparotomy for small intestinal volvulus. Two continuous catheter sets were used for a bilateral continuous block with levobupivacaine 0.25% at a rate of 5-8 mL/h. No complications during the execution of the block were recorded. No supplemental opioids were administered and the patient was hemodynamically stable, requiring no pharmacological cardiovascular support during surgery. At the end of the surgical procedure, the patient received a continuous flow of 0.2% levobupivacaine as postoperative analgesia, at a basal flow of 4 mL/h per each side, a bolus of 4 mL, and a lockout time of 60 min was used. The postoperative pain on the Numeric Rating Scale was 2 at rest and it was 4 in motion, without neurological or respiratory sequelae due to block in the first 72 h after surgery.

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A Case of Necrotizing Periodontitis in a Care-Requiring Elderly Person Treated and Managed by Interprofessional Collaboration.

Necrotizing periodontitis (NP) is a reactive and destructive inflammatory process that occurs in response to bacterial infection. Predisposing factors such as compromised host immune responses contribute significantly to NP pathogenesis. NP occasionally progresses to a more advanced and life-threatening state.

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Oxygen-Ozone Therapy Associated with Alpha Lipoic Acid Plus Palmitoylethanolamide and Myrrh versus Ozone Therapy in the Combined Treatment of Sciatic Pain Due to Herniated Discs: Observational Study on 318 Patients.

The aim of our observational study is to compare the therapeutic efficacy of combined treatment of oxygen-ozone therapy and oral treatment with alpha-lipoic acid (ALA) + palmitoylethanolamide (PEA) and myrrh in patients with peripheral neuropathic pain (sciatica) on radicular disc conflict from disc herniation and the results obtained with oxygen-ozone treatment alone.

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