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Expert opinion Drug interactions involving CAIs may be used both for monitoring the clinical efficacy of these agents when co-administered with other drugs but also for better controlling some diseases, such as hypoxic tumors, case for which the combination of CAIs with other anticancer agents (histone deacetylase inhibitors, alkylating agents, antimetabolite nucleosides, angiogenesis inhibitors, and immune checkpoint inhibitors) proved to be synergistic.Introduction Despite increased interest in the pharmacotherapy of bipolar disorder during pregnancy and the postpartum period, management of the disorder during these critical periods in a woman's life remains challenging.Areas covered The authors review the effect of pregnancy and the postpartum period on the course of bipolar disorder, describe adverse pregnancy and birth outcomes, and discuss the pharmacotherapy of bipolar disorder during and after pregnancy.Expert opinion When treating women with bipolar disorder of childbearing age, clinicians should consider the possibility of pregnancy. PTC-209 Pre-conception counseling should be an integral part of the overall plan to manage bipolar disorder during and after pregnancy. Peripartum management of bipolar disorder is challenging and requires balancing of risks associated with the use of drugs and the potentially deleterious effects of untreated bipolar disorder on the fetus/child. Formulation of personalized treatment requires knowledge of both current (episode type, symptom severity, psychiatric comorbidity, and safety concerns) and historical (episode frequency, response to drugs and psychotherapy, and the effect of reproductive events including pregnancy and postpartum period) factors. Close monitoring is essential for early detection and management of mood episodes. Routine safety assessments are necessary to identify women at risk of harming themselves or the newborn.Antiretroviral therapy adherence among transgender (trans) women living with HIV (WLWH) is negatively impacted by depression and post-traumatic stress disorder (PTSD). Yet, little is known about factors associated with depression or PTSD among trans WLWH. Using cross-sectional data from a national community-based study of 1422 WLWH (n = 53 trans women), we characterized the prevalence of depressive and PTSD symptoms among trans WLWH and examined associations between factors (e.g., Trans stigma) and depressive and PTSD symptoms. Nearly half of participants reported clinically significant PTSD (45.3%) and depressive symptoms (45.3%) [mean Post-traumatic Stress Disorder Civilian Checklist Version-C score 13.8 (SD = 5.8); mean Center for Epidemiological Studies - Depression score 9.4 (SD = 8.0)]. Univariate linear regression analyses showed that less then 95% adherence, higher internalized HIV-related stigma, frequency of past-month hazardous alcohol use, and current injection drug use were significantly associated with both higher PTSD and depressive symptom scores, and higher resilience and social support with lower scores. A history of violence in adulthood was associated with higher depressive symptoms scores, whereas sexual relationship power and less difficulty meeting housing costs were associated with lower scores. Findings suggest a need for multi-level interventions to reduce barriers to mental wellbeing while fostering resilience and social support.We aimed to understand the etiology behind the abnormal craniofacial contour and other clinical presentations in a number of children with Robinow syndrome. Seven children with Robinow syndrome were enrolled in this study (autosomal recessive caused by homozygous mutations in the ROR2 gene on chromosome 9q22, and the autosomal dominant caused by heterozygous mutation in the WNT5A gene on chromosome 3p14). In the autosomal recessive (AR) group, the main clinical presentations were intellectual, disability, poor schooling achievement, episodes of headache/migraine, and poor fine motor coordinative skills, in addition to massive restrictions of the spine biomechanics causing effectively the development of kyposcoliosis and frequent bouts of respiratory infections. Three-dimensional reconstruction computed tomography scan revealed early closure of the metopic and the squamosal sutures of skull bones. Massive spinal malsegmentation and unsegmented spinal bar were noted in the AR group. In addition to severe mesomelia and camptodactyly, in the autosomal dominant (AD) group, no craniosynostosis but few Wormian bones and the spine showed limited malsegemetation, and no mesomelia or camptodactyly have been noted. We wish to stress that little information is available in the literature regarding the exact pathology of the cranial bones, axial, and appendicular malformations in correlation with the variable clinical presentations in patients with the 2 types of Robinow syndrome.The British Mandate in Palestine ended abruptly in 1948. The British departure engendered a complex situation which affected all areas of life, and the country's health system was no exception. Gradual transition of the infrastructure was almost impossible owing to the ineffectiveness of the committee appointed by the United Nations. The situation was further complicated by the outbreak of the Arab-Israeli War. We relate for the first time the story of 75 Jewish patients who were left in a former British mental hospital in Bethlehem - deep behind the front lines. Despite the hostilities, there were complex negotiations about relocating those patients. This episode sheds light on the Jewish and Arab relationship as it pertained to mental institutions during and immediately after the British Mandate.Introduction Given that hydrophobic active pharmaceutical ingredients (APIs) intended for oral delivery comprised about 68% of US FDA approvals in 2019 alone, the impact of endogenous gastrointestinal (GI) molecules on their inherently unstable solution behavior needs to be elucidated.Areas covered The interactions between hydrophobic API's and GI phospholipids, bile acids/salts and digestive proteins are explored. The impact of the complex relationship between the GI molecules and hydrophobic APIs on solubilization by micelle formation, complexation or by inhibiting the nucleation of high energy forms of hydrophobic APIs, so called supersaturating drug delivery systems is complex. The ability of these endogenous GI molecules to manipulate the solution behavior of hydrophobic APIs has been demonstrated both at their native concentrations and when included as exogenous formulation additives. Specific studies of the impact of proteins and mixed micelles on solubilization and crystallization are reported.Expert opinion Elucidation of the complex molecular interactions between orally administered hydrophobic APIs and endogenous GI molecules will enable better in vivo/in vitro correlation and potentially lead to formulation strategies that avoid the stochastic nature of hydrophobic API precipitation in the GI tract.
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