What are therapeutic alternatives for Clindamycin Phosphate Injection?

Comment by InpharmD Researcher

Our analysis involved various tools, including R (version 4.2.2), VOSviewer (version 1.6.18), CiteSpace software (version 6.2.R1), and an online bibliometric platform. Our findings identified a total of 1170 articles published between 2012 and 2022, indicating a consistent growth of research interest in this area. Notably, China significantly contributed with 40.7% (374) of the publications, signifying its prominent role in this field. Among the journals, the Journal of Alzheimer's Disease published the highest number of articles (57; 4.9%). In terms of author influence, Wang Y, with an H-index of 13, emerged as the most influential author. Additionally, Shanghai Jiaotong University was the most productive institution, accounting for 66 articles (5.6%). Through keyword analysis, we grouped high-frequency keywords into six clusters: gut microbiota, AD, neuroinflammation, gut-brain axis, oxidative stress, and chain fatty acids. Chain fatty acids, oxidative stress, and the gut-brain axis emerged as dominant research topics in the past five years. Recent studies have specifically focused on "nlrp3 inflammasome" and "clearance" (2020-2022), indicating shifting research interests within this field.

  

This bibliometric analysis aims to provide insights into the evolving landscape of research on the gut microbiota and AD. Our results identify key research trends and themes while highlighting potential research gaps. The findings offer valuable perspectives for future investigations, advancing our understanding of AD and exploring potential therapeutic strategies.

Background

The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. Significant changes in blood flow or in the integrity of cerebral vessels are believed to cause cerebrovascular disease (CVD) and to contribute to dementias including Alzheimer’s disease [1]. Stroke, the most serious form of CVD, is one of the leading causes of death and adult disability worldwide. Acute treatments for stroke, however, are severely limited. Neuroprotective drugs under development show promise at halting the ischemic cascade, but as yet, no such compound has received federal approval in the United States. One of the biggest limitations to this development is the lack of understanding of the mechanisms by which cerebral vessels react to factors such as ischemia, inflammation, blood pressure changes, metabolic demands, and trauma [2]. In order to address these fundamental questions, functional brain imaging techniques such as fMRI and intrinsic signal optical imaging (ISOI) have emerged as tools to visualize and quantify cerebral hemodynamics. [1]

In the neuroscience community, ISOI has long been used to study the organization and functional architecture of different cortical regions in animals and humans [3–5] (see other chapters in this book). Three sources of ISOI signals that affect the intensity of diffusely reflected light derive from characteristic physiologic changes in the cortex. For functional neuronal activation, these have been observed to occur over a range of timescales, including (1) light scattering changes, both fast (over 10 s of milliseconds) and slow (i.e., > ~0.5 s) (2) early (~0.5–2.5 s) absorption changes from alterations in chromophore redox status, i.e., the oxy/deoxy-hemoglobin ratio (known as the “initial dip” period), and (3), slower (~2–10 s) absorption changes due to blood volume increase (correlated with the fMRI BOLD signal). Light scattering changes have been attributed to interstitial volume changes resulting from cellular swelling, organelle swelling due to ion and water movement, capillary expansion, and neurotransmitter release [6], [7]. The slower absorption factors have been demonstrated to correlate with the changes in metabolic demand and subsequent hemodynamic cascades following neuronal activation. The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. [2], [3]

There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. Using animal models of acute and chronic brain injury, ISOI has been used to quantify the acute hemodynamic events in response to stroke, including focal ischemia and cortical spreading depression (CSD) [10–21]. Researchers have also used ISOI to locate and quantify the spatial extent of the stroke injury, including ischemic core, penumbra, and healthy tissue zones [18], [19], [20], [21], [22]. CSD also plays a key role in migraine headache, and recent laser speckle imaging studies have revealed the neurovascular coupling mechanism to the transmission of headache pain. Two new dimeric lindenane-type sesquiterpenoids (1 and 2, named chlorasessilifols A and B, resp.), one new ent-podocarpane-type C17 norditerpenoid (3), and one new ent-torarane-type diterpenoid (4), along with seven known terpenoids, were isolated from the whole plant of Chloranthus sessilifolius. The new structures were established by means of spectroscopic methods and/or observed cotton effects in the circular dichroism spectra. Among the isolates, 3α,7β-dihydroxy-ent-abieta-8,11,13-triene (11) exhibited significant anti-neuroinflammatory activity by inhibiting the nitric oxide production in lipopolysaccharide-stimulated murine BV-2 microglial cells, with an IC50 value of 4.3 μM. [4]

Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. Quantitative diffuse optical methods [27] such as spatially-resolved reflectance, diffuse optical spectroscopy (DOS), and tomography (DOT), and diffuse correlation spectroscopy (DCS) possess exquisite sensitivity to these functional and structural alterations associated with brain injury, and have been applied to the study of CSD [11,15,28]. DOS and DOT utilize the near-infrared spectral region (600–1000 nm) to separate and quantify the multispectral absorption (μa) and reduced scattering coefficients (μs′), providing quantitative determination of several important biological chromophores such as deoxy-hemoglobin (HbR), oxy-hemoglobin (HbO2), water (H2O), and lipids. Concentrations of these chromophores represent the direct metrics of tissue function such as blood volume fraction, tissue oxygenation, and edema. Additionally, the scattering coefficient contains important structural information about the size and density of scatterers and can be used to assess tissue composition (exctracellular matrix proteins, cell nuclei, mitochondria) as well as follow the process of tissue remodeling (wound healing, cancer progression). DOS utilizes a limited number of source-detector positions, e.g., 1–2, but often employs broadband content in temporal and spectral domains [29]. In contrast, DOT typically utilizes a limited number of optical wavelengths (e.g., 2–6) and a narrow temporal bandwidth, but forms higher resolution images of subsurface structures by sampling a large number of source-detector “views.” To achieve maximal spatial resolution, the ideal DOT design would employ thousands of source-detector pairs and wavelengths. However, several engineering considerations including measurement time and instrument complexity currently limit the practicality of this approach. [5]

References:

[1] Imtiaz S, Shield KD, Fischer B, Elton-Marshall T, Sornpaisarn B, Probst C, Rehm J. Recent changes in trends of opioid overdose deaths in North America. Subst Abuse Treat Prev Policy. 2020 Aug 31;15(1):66.
[2] Wang LJ, Xiong J, Liu ST, Pan LL, Yang GX, Hu JF. J Nat Prod. 2015 Jul 24;78(7):1635-46. doi: 10.1021/acs.jnatprod.5b00195. Epub 2015 Jul 1.
[3] Wang LJ, Xiong J, Liu ST, Liu XH, Hu JF. Chem Biodivers. 2014 Jun;11(6):919-28. doi: 10.1002/cbdv.201300283.
[4] Zhang M, Wang JS, Oyama M, Luo J, Guo C, Ito T, Iinuma M, Kong LY. J Asian Nat Prod Res. 2012;14(7):708-12. doi: 10.1080/10286020.2012.685724. Epub 2012 May 10.
[5] Wang AR, Song HC, An HM, Huang Q, Luo X, Dong JY. Chem Biodivers. 2015 Apr;12(4):451-73. doi: 10.1002/cbdv.201300376.

Relevant Prescribing Information

The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. The International Association for the Study of Pain defines chronic pain as any pain lasting longer than three months. There are multiple sources of chronic pain. Combination therapy for pain includes both pharmacological therapies and nonpharmacological treatment options. There is a more significant reduction in pain with combination therapy compared to a single treatment alone. Escalation of pharmacological therapy is in a stepwise approach. Comorbid depression and anxiety are widespread in patients with chronic pain. Patients with chronic pain are also at increased risk for suicide. Chronic pain can impact every facet of a patient's life. Thus learning to diagnose and appropriately manage patients experiencing chronic pain is critical. [6], [7]

References:

[6] Nahin RL. Estimates of pain prevalence and severity in adults: United States, 2012. J Pain. 2015 Aug;16(8):769-80.
[7] Wang AR, Song HC, An HM, Huang Q, Luo X, Dong JY. Chem Biodivers. 2015 Apr;12(4):451-73. doi: 10.1002/cbdv.201300376.

Literature Review

A search of the published medical literature revealed 1 study investigating the researchable question:

What are therapeutic alternatives for Clindamycin Phosphate Injection?

Level of evidence

C - Multiple studies with limitations or conflicting results  Read more→



Please see Table 1 for your response.


 

Enter title in bold, with all first words capitalized, and without a reference number

Design

Objective terms describing the type of study (randomized, uncontrolled, retrospective, placebo-controlled, cross-over, etc.); N= (total subjects)

Objective

State the objective (purpose) of the study using the author’s language(usually beginning with “To” and without a period, assuming a non-complete sentence)

Study Groups

Only the separate groups and their cohort number (n) should be listed. You can describe more details of the cohorts in the methods section so this section can stay very succinct.

Inclusion Criteria

Include relevant inclusion criteria (not a comprehensive list).

Exclusion Criteria

Include relevant exclusion criteria (not a comprehensive list).

Methods

This is our most important section. Data collection and any other information needed to understand the results is presented. Any loose ends from all other sections are tied up here, as concisely as possible.

Duration

Include the duration of the trial as a whole, as well as the duration of the interventions.

Outcome Measures

If the primary outcome measure isn’t explicit from the study, all outcome measures applicable to the inquiry can be listed in this section. If the primary outcome measure is explicit, then make separate sections for ‘Primary’ and ‘Secondary’ Outcome Measures.  


All outcome measures listed should correlate directly/exactly with the results presented later.

Baseline Characteristics

 

A

B

 

Age, years

     

Female

     

White

     

---

     

Include relevant baseline characteristics that will provide a general (big picture) view of the patients in the study.

Results

Endpoint

A

B

p-Value

----

     

----

     

All results listed should correlate directly/exactly with the outcome measures presented previously.Results that do not have to do with the inquiry should not be included; just the stated outcomes need corresponding results.


Tables are encouraged to display the most info using the least space/words.

Adverse Events

Common Adverse Events: (or those deemed frequent; if not listed in study, use N/A or “Not disclosed”)

Serious Adverse Events: (or those deemed high risk; if not listed in study, use N/A or “Not disclosed”)

Percentage that Discontinued due to Adverse Events: (if not listed in study, use N/A or “Not disclosed”)

Study Author Conclusions

Copy and paste the author’s conclusions on the question at hand, using full sentences. Don’t include any conclusions that don’t correspond to results we list.

InpharmD Researcher Critique

As the expert, add 1-2 sentences on strengths, weaknesses, and takeaways from this study. Focus on insight as “more research is needed” is obvious.