Prasterone/Estradiol/Drospirenone

Arctiin (ARC), a primary component of burdock (Arctium lappa L.), is widely recognized as a traditional herb and nutritional supplement in Asia. This study set out to explore its potential impact on type 2 diabetic osteoporosis (T2DOP). MC3T3‐E1 cells were exposed to a high‐glucose environment to simulate diabetic conditions. Treatment with ARC increased the expression of crucial osteogenic transcription factor genes, such as RUNX2, Osterix, and COL1A1. Moreover, ARC mitigated the production of ROS induced by high glucose levels. For in vivo experimentation, db/db mice were used as models for T2DOP. ARC supplementation decreased bone loss and improved bone structural integrity. Collectively, our findings indicate that ARC holds promise as a nutritional intervention for the treatment of T2DOP. By activating the Nrf2/HO‐1 signaling pathway, ARC could help counteract oxidative stress and impaired bone differentiation associated with diabetes, thus offering a potential dietary strategy to support bone health. Incorporating ARC‐containing foods or supplements into the diet could be a beneficial approach to enhance overall bone quality and potentially reduce the risk of fractures and other bone‐related problems in patients with diabetes, highlighting the importance of considering natural compounds for the nutritional management of chronic diseases.

Rates of carbapenem-resistant Acinetobacter baumannii are rising in Thailand. Although high-dose (HD) sulbactam is recommended for treating carbapenem-resistant A. baumannii infections, data on plasma sulbactam concentrations in children are limited. We aimed to evaluate plasma sulbactam concentrations and pharmacokinetic-pharmacodynamic (PK-PD) target achievement in pediatric patients.

Prospective study data (January–November 2023) on children (1 month–18 years) who received sulbactam every 6–8 hours were analyzed. Mid-dosing (Cmid, 50% fT) and trough (Ctrough, 100% fT) concentrations were evaluated. PK-PD target achievement [50% fT > minimum inhibitory concentration (MIC), 100% fT > MIC] was evaluated using Clinical and Laboratory Standards Institute 2024 MIC cutoffs and MIC data of isolates of Acinetobacter calcoaceticus–baumannii complex from this study.

Thirty-five patients (median age 50 months) were categorized into standard-dose (SD) or HD groups. The geometric mean Cmid was higher in the HD (41.3 mg/L) versus SD (19.5 mg/L) groups (P = 0.006). Among 101 isolates of Acinetobacter calcoaceticus–baumannii complex, the MIC50 and MIC90 (concentrations that inhibit 50% and 90% of isolates of the A. calcoaceticus–baumannii complex) were 16 and 128 mg/L, respectively. The HD group achieved Cmid >MIC50 in 87.5% of the patients compared with 63.6% in SD (P = 0.17). Within the HD group, patients with augmented renal clearance (ARC) had lower Cmid (geometric mean 31.9 mg/L) compared with non-ARC (geometric mean 63.4 mg/L) (P = 0.04).

HD sulbactam resulted in higher Cmid and PK-PD achievement. ARC significantly compromised plasma sulbactam concentration. HD sulbactam may be preferable for treating critically ill pediatric patients and those with ARC, especially during the empirical period.