Gout disease is recognized as one of the most prevalent forms of arthritis worldwide, with an estimated prevalence of around 2.5%. Its pathophysiology is primarily linked to elevated levels of uric acid in the bloodstream, which may result from either increased production or reduced renal excretion. Clinically, it often presents as a swollen, erythematous, and painful joint. The definitive method for diagnosis remains synovial aspiration from the affected joint. While acute attacks typically require management in the emergency department, long-term care is generally provided in primary care settings.This literature review aims to explore gout disease in terms of its clinical features, diagnostic approaches, and treatment strategies, particularly focusing on the role of primary care. A comprehensive search was conducted on the PubMed database using the MeSH term “gout disease” to identify pertinent studies. Gout disease continues to be among the most widespread rheumatologic conditions globally, and unhealthy lifestyle choices, including alcohol intake and high consumption of red and white meats, may exacerbate its incidence. Diagnosis may involve blood tests, radiographic imaging, and joint aspiration. Maintenance therapy, often administered in primary care, includes the use of Allopurinol or other urate-lowering agents.
Digoxin, a cardiac glycoside, is commonly prescribed for the management of congestive heart failure, atrial fibrillation or flutter, and certain cardiac arrhythmias. However, its clinical use is limited by its narrow therapeutic index, which predisposes patients to toxicity. At elevated concentrations, digoxin toxicity can present with gastrointestinal disturbances, visual changes, and cardiac arrhythmias. This systematic review aims to summarize reported cases of digoxin toxicity, focusing on associated risk factors, drug-drug interactions, and clinical manifestations. A comprehensive literature search was conducted using PubMed and Ovid MEDLINE with the keywords “digoxin” and “toxicity.” Clinical and laboratory features of toxicity were extracted and analyzed. Of the 2,399 articles identified, only 10 met the inclusion criteria for final review. In 4 of the 10 cases, diuretics were implicated as interacting medications. Commonly reported symptoms included nausea, vomiting, visual disturbances, bradycardia, and elevated serum digoxin levels. Identified risk factors for toxicity included female sex, advanced age (60–91 years), renal impairment, and concomitant drug use. Notably, toxicity was observed even at therapeutic or low serum digoxin concentrations in the presence of these risk factors. The most frequent clinical manifestations were gastrointestinal symptoms, vision changes, and bradycardia.
Producing enantiomerically pure drugs from racemic mixtures has become a critical objective in modern pharmaceutical science. Racemic compounds typically consist of two or more enantiomers, of which only one may be therapeutically active, while the others may be biologically inactive or even toxic, including teratogenic effects. Hence, the ability to effectively isolate the desired enantiomer is essential for ensuring both the safety and effectiveness of pharmaceutical treatments. This mini-review provides an overview of recent innovations in chiral stationary phases (CSPs) employed for the resolution of racemic drugs and mixtures. It covers various classes of CSPs, including those based on Pirkle-type selectors, polysaccharides, polypeptides, inclusion complexes, ligand-exchange mechanisms, macrocyclic antibiotics, and other novel materials. The performance of these phases in a range of separation techniques—such as high-performance liquid chromatography (HPLC), gas chromatography (GC), capillary electrophoresis (CE), supercritical fluid chromatography (SFC), and simulated moving bed (SMB) chromatography—is examined. Emphasis is also placed on the types of molecular interactions between CSPs and target analytes that drive effective enantioseparation.
This review aims to explore and consolidate the therapeutic potential of colchicine, one of the oldest yet still widely used treatments. Colchicine is an alkaloid compound known for its anti-inflammatory and analgesic effects. It has been effectively used to treat conditions such as gout, familial Mediterranean fever (FMF), and Behcet’s disease. The drug’s mechanism of action involves its interaction with tubulin, a structural component of the cytoskeleton, which disrupts neutrophil functions, including adhesion, migration, and chemotaxis. Colchicine specifically inhibits tyrosine phosphorylation, a key process for neutrophil activation, and affects neutrophil deformability, preventing their extravasation. Additionally, it suppresses the production of superoxide and pro-inflammatory cytokines, such as interleukin 1β and IL-6. The drug also inhibits inflammasome activity, hindering caspase-1 activation and interleukin release. Colchicine has attracted attention during the COVID-19 pandemic due to its potential to treat severe cases and reduce mortality. It is a cost-effective and widely accessible drug with a relatively safe profile. However, its metabolism can be influenced by CYP3A4 and P-glycoprotein inhibitors, as well as by renal and hepatic impairments. Common side effects include gastrointestinal disturbances such as diarrhea, nausea, and vomiting.
Snakebite envenoming remains a significant global health challenge, with high mortality and morbidity rates persisting despite decades of medical attention. Each year, millions are affected by venomous snakebites, often resulting in death or severe disability. Snake venoms exhibit diverse bioactivities, including hemorrhagic, inflammatory, cytotoxic, cardiotoxic, and neurotoxic effects, mainly due to complex mixtures of toxin-rich proteins. Although considerable research has been undertaken, the majority of venom components remain uncharacterized. Recent advancements in proteomics and bioinformatics have enabled more detailed exploration of venom profiles, facilitating the identification and functional prediction of novel toxins. Computational approaches now enable modeling of toxin-target interactions, aiding understanding of venom mechanisms. This review also explores the emerging role of medicinal plants in snakebite treatment, alongside conventional antivenoms. Emphasis is placed on the urgent need to improve access to safe, affordable, and effective antivenoms in low-income tropical regions and to promote their appropriate clinical use.
The growing use of muscle-enhancing steroids, particularly anabolic-androgenic steroids (AAS), has raised significant concerns about their potential adverse effects on cardiovascular health, with heart attacks being a key risk. This study offers an in-depth exploration of the relationship between muscle-enhancing drugs and heart attacks. It examines the physiological processes by which steroids may lead to cardiovascular complications, such as hypertension, dyslipidemia, atherosclerosis, and thrombosis. The research also evaluates the epidemiological data that links steroid use to a higher likelihood of heart attacks and other cardiovascular incidents. In addition, the study addresses the ethical issues surrounding steroid use in sports and fitness, as well as the regulatory measures in place to combat abuse. The importance of interdisciplinary collaboration and evidence-driven strategies to tackle this public health challenge is emphasized. Ultimately, the study advocates increased awareness, more extensive research, and stronger preventive efforts to reduce the cardiovascular risks associated with muscle-enhancing steroids, while encouraging safer alternatives for fitness enhancement.
Eurasian Academy of Medicine and Dentistry