Malvina Hoxha

Scopus Publications

Health economic evaluations of myasthenia gravis: a systematic review
Frenki Çipi, Chantal Koloneci, Artejana Marku, Kamila Domi, Xhoana Tahiraj, Visar Malaj, Malvina Hoxha
Croatian Medical Journal, 2025
AimTo systematically review the latest pharmacoeconomic evidence regarding the costs associated with myasthenia gravis (MG) care and treatment. MethodsWe searched the National Health Service Economic Evaluation Database and PubMed for articles in English from any country reporting health economic analyses of pharmacological treatments, hospitalization, or surgical procedures related to MG. ResultsThe study included 31 articles showing a considerable variability in the costs and cost-effectiveness of MG treatments across regions, therapies, and health care settings.Traditional therapies such as plasma exchange (PLEX) and intravenous immunoglobulin (IVIg) differ notably in cost, with PLEX generally being less expensive.Newer clinically effective treatments such as efgartigimod and eculizumab raise concerns about their economic sustainability, whereas rituximab might be a more affordable alternative in certain contexts. ConclusionFuture research should compare cost-effectiveness across health care systems, incorporating local pricing and reimbursement, and collecting real-world data.
Healthcare worker views on antimicrobial resistance in chronic respiratory disease
Sachin Ananth, Adekunle O. Adeoti, Animesh Ray, Peter G. Middleton, Miquel Ekkelenkamp, Stephanie Thee, Anand Shah, , Abayomi Fadeyi, Abdoul Risgou Ouedraogo, Addishiwot Melesse Seminew, Adele Roux, Adnan Zafar, Aizhamal Tabyshova, Aleksandra Barac, Alex Gileles-Hillel, Alexander Kiefer, Alexandra Hebestreit, Alice Tebboth, Amelia Shoemark, Ana Machado, André Santos-Silva, Andrea Gramegna, Andriy Serediuk, Angela Tramontano, Anna Salina, Annie Navarro Rolon, Anoop Prakash, António Gonçalves, Aran Singanayagam, Arun H. Mahadevaiah, Asha Muthusami, Avinash Aujayeb, Ayşe Önal Aral, Barbara Kahl, Ben Huggon, Bohdana Pereviznyk, Braulio Chevalier Vidal, Bukar Bakki, Bulent Karadag, Bushra Ahmed, Calmés Doriane, Cao Pham Ha Giang, Carmelo Sofia, Catia Cilloniz, Cátia Paixão, Charl Verwey, Charles Feldman, Charlotte Carter, Chiara Premuda, Chizoba Efobi, Clementine Fraser, Corentine Alauzet, Damir Vukoja, Danial Naqvi, Daniela Maria Cirillo, Dareen Marghlani, Daryl Butler, David Abelson, David Stickells, Deepa Kumari Shrestha, Deepa Patel, Devesh J. Dhasmana, Devi Jyoti Dash, Diana Ergle, Dilara Ömer Topçu, Dominic L. Sykes, Dorina Rama Esendagli, Dumitras Tatiana, Efthymia Papadopoulou, Elsa Branco, Eva Van Braeckel, Evans Frexon Liseki, Evie Alexandra Robson, Fapohunda Temitope Victoria, Maria de Fatima Magalhaes Gonzaga, Felix Bongomin, Felix C. Ringshausen, Felix Manyeruke, Freddy Frost, Friso de Weert, Garante Carmela Melania, Garry McDonald, Geneviève Héry-Arnaud, Giancarlo De Leo, Gina Amanda, Gioia Piatti, Giovanna Manfredini, Grillon Antoine, Guillaume Thouvenin, Gunar Günther, Hélida Conceição Cavalcante Torres, Helle Krogh Johansen, Henny Azmanov, Hussein Elkhayat, Hussein Mohamed Ahmed, Ian Clifton, Ignacio Martin-Loeches, Indiane Putri Ningtias, Ines Azevedo, Inge Muylle, Irfan Shafiq, Iwein Gyselinck, Joel Israëls, Jaber S. Alqahtani, James Ayodele Ogunmodede, Jamil Jubrail, Jatin G. Nagar, Jeanne-Marie Perotin, Jimstan Periselneris, Jo Congleton, Johnmary T. Arinze, Joseph Fadare, Joy Eze, Justus Simba, Kartik Kumar, Katharine Hurt, Kay Roy, Koen Verbeke, Kristi Reveli, Krystyna Poplawska, Kwok Wang Chun, Lawani Olufemi Ademola, Leidy Prada, Leonardo Gori, Letizia Corinna Morlacchi, Linda Aprillia Rolobessy, Lisa Nwankwo, Lorenzo Carriera, Loskova Elena Vladimirovna, Lydia Finney, Mai S. Elsheikh, Malvina Hoxha, Marcos I. Restrepo, Margarete Lopes Teixeira Arrais, Maria Gabrovska, Maria Grazia Cagnazzo, Maria Joana Catarata, Marialuisa Bocchino, Mario Di Stasio, Marrah Lachowicz-Scroggins, Mary Wambura, Matlawene John Mpe, Matthew Pavitt, Mattia Nigro, Melanie Sue Collins, Michelle Uno, Miguel Gallego, Milind Sathe, Mine Kalyoncu, Mohammad Abdullah, Mona Lichtblau, Mukesh Singh, Mwanaada Ahmad Kilima, Natalie Lorent, Nazanin Farahbakhsh, Ngoc Duong-Minh, Nguyen Pham Anh Hong, Nicola Ronan, Nicola Travaglini, Nilotpal Bhattacherjee, Nilüfer Aylin Acet Öztürk, Nina Ratu Nur Kharima, Niranjan Chandramal Lehupe Bandarage, Nishith Kumar, Nita Corry Agustine Nias, Nwosu Nnamdi Ikechukwu, Oleksandr Mazulov, Olga Bielousova, Olga Mashedi, Omer Elneima, Ophir Bar-On, Özge Aydın Güçlü, Pabitra Banerjee, Pavel Yordanov, Pedro Gonçalo Ferreira, Pieter Goeminne, Prakash Mohan Jeena, Priti Kenia, Priyanka Poda, Pujan H. Patel, Rafiuk Cosmos Yakubu, Rameesha Khalid, Ranganath Thippanahalli Ganga, Rasheedat Mobolaji Ibraheem, Ravini Karunatillake, Rawya Ahmed, Ricardo Figueiredo, Richard Hewitt, Ridzuan Mohsin, Rodrigo Abensur Athanazio, Rohit Kumar, Rosanel Amaro, SRaghul Raj, Sabi Hippolyte, Sabrine Louhaichi, Salvatore Tripodi, Sandra Rovira-Amigo, Sanem Eryılmaz Polat, Sara Manti, Sarah Loof, Saurabh Singh, Sega Pathmanathan, Serena Romeo, Shirley V. Cuan-Escobar, Silvia Castillo-Corullón, Sinchuk Nataliya, Siobhan B. Carr, Siyu Dai, Snezhina Lazova, Sonja van Scheijen, Sophie Gohy, Soumitra Mondal, Srimali Wijesundara, Stavros Tryfon, Stefano Aliberti, Stephan Illing, Suleiman Sherifat Tinuke, Sumudu Withanage, Susanne Hämmerling, Tariq Qadeer, Tavs Qvist, Tehreem Ahmad, Temitope Victoria Fapohunda, Thomas Guillard, Till Othmer, Tim Felton, Tony De Soyza, Toufic Chaaban, Vanessa Kahr, Vânia Fernandes, Vera Clérigo, Veroniek Saegeman, Vikram Damaraju, Vipula Rasanga Bataduwaarachchi, Vivek Gundappa, Yannick Vande Weygaerde
Antimicrobial Resistance and Infection Control, 2025
Background and objective Antimicrobial resistance (AMR) is a global crisis, however, relatively little is known regarding its impact in chronic respiratory disease and the specific challenges faced by healthcare workers across the world in this field. We aimed to assess global healthcare worker views on the challenges they face regarding AMR in chronic respiratory disease. Methods An online survey was sent to healthcare workers globally working in chronic respiratory disease through a European Respiratory Society clinical research collaboration (AMR-Lung) focussed on AMR in chronic lung disease. Responses from different geographic regions were analysed. Results 279 responses were received across 60 countries. 54.5% of respondents encountered AMR in chronic respiratory disease weekly. There were differences in perceived high-priority diseases and species with AMR burden between Europe, Asia and Africa. 76.4% of respondents thought that inappropriate antimicrobial prescribing in chronic respiratory disease was common. However, only 43.4% of respondents thought that there were adequate antimicrobial stewardship programmes in their area for chronic respiratory disease, with limited availability in outpatient (29.0%) and ambulatory settings (24.7%). Developing rapid diagnostics for antimicrobial susceptibility (59.5%) was perceived to be the most common challenge in implementing antimicrobial stewardship, with an improved understanding of regional epidemiology of AMR strains the most important factor to improve outcome (55.2%). Conclusions AMR has significant perceived burden in chronic respiratory disease by healthcare professionals globally. However, current implementation of antimicrobial stewardship is limited, with significant challenges related to the availability of rapid diagnostics and understanding of regional epidemiology of AMR strains.
Natural Compounds Targeting SIRT1 and Beyond: Promising Nutraceutical Strategies Against Atherosclerosis
Elisa Domi, Malvina Hoxha
Nutrients, 2025
Background/Objectives: Atherosclerosis remains a leading cause of morbidity and mortality worldwide, with an urgent need for novel preventive and therapeutic strategies. Sirtuin 1 (SIRT1), an NAD+-dependent deacetylase, has emerged as a central regulator of vascular homeostasis, modulating oxidative stress, inflammation, lipid metabolism, and endothelial function. Increasing evidence highlights that some natural activators of SIRT1 may be interesting in mitigating the development of cardiovascular diseases. Methods: Searching in the main databases PubMed and Scopus, we made a literature revision, including studies from January 2000 to June 2025, of the major natural SIRT1 activators involved in vascular impairment in order to investigate their potential therapeutic use in atherosclerosis. Results: Among them, resveratrol, quercetin, naringenin, and hydroxytyrosol show the strongest evidence in activating SIRT1 and modulating the essential molecular pathways involved in atherosclerotic disease. These findings span from preclinical to clinical studies, with limited randomized clinical trial data for hard cardiovascular outcomes. Conclusions: This review synthesizes current knowledge on natural SIRT1 activators in the context of atherosclerosis, emphasizing their molecular mechanisms and clinical perspectives. The concept of using nutraceuticals-based interventions targeting SIRT1 may pave the way for innovative strategies in cardiovascular diseases.
An Overview of the Role of Medicinal Plants in Parkinson’s Disease: A Semi-Systematic Review
Hedie Haxhiu, Malvina Hoxha, Ina Zela, Bruno Zappacosta
Biomedicines, 2025
Background/Objectives: Parkinson’s disease (PD) is a complex nervous system disorder characterized by the gradual loss of dopaminergic neurons, leading to disturbances in movement, such as resting tremors, rigidity, bradykinesia, or akinesia; postural issues; and freezing (motor block). Due to the limitations and side effects of current pharmacological treatments, there is a growing interest in investigating the therapeutic potential of medicinal plants. Methods: A semi-systematic review was conducted using PubMed, Web of Science, and Scopus as main databases, identifying original research articles, systematic reviews, and relevant preclinical or clinical studies published between January 2000 and December 2024. We selected seven plants primarily for their neuroprotective effects, supported by preclinical and animal data. Only articles in English were included in the study. Results: Seventeen articles were included in the study. The results showed that Curcuma longa, Gastrodia elata blume, Ginkgo biloba, Paeonia alba radix, Pueraria lobata, Scutellaria baicalensis, and Withania somnifera have a neuroprotective role, capable of slowing down the progression of PD with different mechanisms of action, ranging from restorative properties of neurons. Conclusions: Developing new drugs based on the respective herb compounds/extracts and herbal formulas is a promising avenue for complementary therapies for PD. However, further preclinical and clinical studies are required to confirm their safety, efficacy, bioavailability, and dosage.
Mycotoxins and neuropsychiatric symptoms: possible role in special refugee populations
Malvina Hoxha, Mariagrazia Abbasciano, Giuseppina Avantaggiato, Bruno Zappacosta, Domenico Tricarico
Frontiers in Pharmacology, 2025
1.IntroductionIn recent years, there has been a growing interest in assessing the role of mycotoxins in different diseases, especially in neurological disorders, and neuropsychiatric symptoms (Ratnaseelan et al., 2018; Nguyen et al., 2021). Mycotoxins are secondary metabolites produced by mold or fungi that contaminate food, and are responsible of biochemical and pathological changes in animals and humans. They can be found especially in cereals, wheat, coffee beans, maize, dried fruits (nuts, almonds, peanuts), dry-cured meat products, spices, rice, and crude vegetable oils (Pleadin et al., 2019). Mycotoxins can also be present in food even in the absence of visible molds, and industrial processing has little effect on their reduction. Moisture content, temperature, humidity, pH, physical damage of the food, are some of the factors that affect the mycotoxin biosynthesis (Richard, 2007). Their elimination from the body depends on the mycotoxin type, and varies from days to years. Controlling every step and condition during food production and storage process is essential in reducing the impact of these food safety hazard in human health. Ochratoxin A (OTA), patulin (PAT), aflatoxins, zearalenone (ZEA), trichothecenes, fumonisins are some of the most common mycotoxins found in food that can be involved in neuropsychiatric symptoms, and in neurological disorders (Von Tobel 2014; Brand et al., 2019; Dai et al., 2024; Kowalska et al., 2016; Feuerstein et al., 2017; Chen et al., 2021).Refugee populations, a group of individuals that cross the international border, and often live in refugee camps, temporary shelters in host countries, or urban areas, are more vulnerable to mycotoxins exposure. Refugees often rely on humanitarian aid for food, and often face resource constraints. In refugee settlements, humanitarian agencies consistently assess for major mycotoxins, such as ochratoxins, aflatoxins, and fumonisins, and reject crops with unsafe levels to protect refugees from exposure. Nevertheless, not all food lots can be tested due to resource limitations, and mycotoxins levels can increase after testing. This may occur during transit or storage, particularly under suboptimal conditions, before the food is prepared for meals. These challenges reveal the need for enhanced monitoring systems, better storage techniques, and robust protocols to ensure food safety throughout the supply chain. By addressing these challenges and implementing practical solutions, humanitarian agencies can more securely safeguard the well-being of refugee populations, reducing the risk of neuropsychiatric symptoms associated with exposure to mycotoxins.The aim of this opinion paper is to discuss the potential role of mycotoxins in neuropsychiatric symptoms in vulnerable populations, such as refugees, who are particularly susceptible to food contamination and prolonged exposure to humid environments—factors that promote mold growth and mycotoxin production. Despite evidence linking mycotoxins to neuropsychiatric symptoms, research on their impact in refugee populations are deficient. This study addresses this gap by evaluating the potential role of mycotoxins exposure in refugees population, their neurological and psychiatric effects, and potential mitigation strategies. Different studies should be conducted to prove this hypothesis, taking in consideration also many confounding factors, such trauma, malnutrition, and chronic stress that might exacerbate the neuropsychiatric consequences of mycotoxin exposure. 2. Mycotoxins and Neuropsychiatric symptomsExposure to mycotoxins is associated with a higher risk of cognitive impairment, depression, anxiety, and other neuropsychiatric symptoms (Ratnaseelan et al., 2018). Different studies have reported many neurological symptoms mycotoxin-associated, such as short-term memory loss, alteration of blink-reflex latency, color discrimination issues (Kilburn, 2003). In a study carried out in 182 subjects exposed to mold, moderate to severe levels of depression, and other physical, cognitive and emotional problems were reported. Patients were characterized by a hypoactivation in the frontal cortex (Crago et al., 2003). The presence of mold was also associated with emotional distress and depression in other studies (Hyndman, 1990; Packer et al., 1994).The depletion of dopamine in mice treated with the OTA mycotoxin may also contribute to an increased risk of anxiety and depression (Pei et al., 2021). In addition, OTA can impair the hippocampal neurogenesis in vivo leading to cognitive impairment, difficulty in learning and concentration, and memory loss. Different studies report that OTA contributes to neurodegenerative disorders through DNA damage, oxidative stress, and mitochondrial dysfunction (Pei et al., 2021; Yoon et al., 2009; Zhang et al., 2009; Mateo et al., 2022). Long-term exposure to OTA can reduce cognitive function and cause attention deficits (Mateo et al., 2022).In addition, fumonisin B1 (FB1) has been shown to have neurotoxic effects, inhibiting neurodevelopment, with increased levels observed in children with neural tube defects (NTD) and autism spectrum disorder (ASD)(Stockmann JH, 2008; Ratnaseelan et al., 2018; Missmer et al., 2006). FB1 also suppresses the immune system, increasing the susceptibility to pathogens, and changing the expression of cytokine (Bulder et al., 2012; Wild et al., 2015). A chronic exposure to FB1can bring to different psychotic symptoms, such as memory disorders, and hallucinations (Chen et al., 2021).PAT is a mycotoxin primarily found in apples and apple products, but also present in moldy fruits like grapes and pears, and has demonstrated neurotoxicity in various animal models (Song et al., 2014; Sabater Vilar et al., 2004). Furthermore, PAT is associated with nerve cell damage, irritability, confusion, alteration of communication between neurons, and uncoordinated movement (Pal et al., 2017; Brand et al., 2019).Aflatoxins are one of the most important classes of mycotoxins, found in agricultural crops and comprising 21 members, all of which are capable of disrupting the blood-brain barrier. Alfatoxin B1 (AFB1) the most toxic member of the family, that has been involved in neurotoxicity, can cause depression, anxiety, memory deficit, and learning disorders (Alsayvah et al., 2019; Dai et al., 2024; Qureshi et al., 2015). Animal models have shown that AFB1 affects neurotransmitter and neuropeptide regulation, leading to neurobehavioral abnormalities.ZEA is another mycotoxin, that resembles estrogen and disrupts the hormone balance leading to irritability, and fluctuating mood (Kowalska et al., 2016).Citrinin (CIT) is a mycotoxin found in wheat, rice, cheese, fermented sausages that can cause neurotoxic effects associated with damage in brain cells. Sleep deprivation, and anxiety are some of the symptoms that CIT can cause (Zargar et al., 2023). Trichothecenes are another class of mycotoxins that can cause neuroinflammation, leading to symptoms such as depression and headaches (Feuerstein et al., 2017). In particular, T-2 toxin, which is a member of trichothecene involved in the changes in neurotransmitters levels, can lead to cognitive impairment and increased irritability(Zhang et al., 2020).3. DiscussionMany studies have reported the role of mycotoxins in low- and middle-income countries, highlighting the need to evaluate intervention measures to prevent fatalities from acute mycotoxin intoxication, as well as the long-term effects from sub-acute exposure. In light of the above mentioned findings, mycotoxins can increase the vulnerability of neuropsychiatric symptoms in patients with already a higher risk, by accelerating the underlying neurologic, or pathologic processes (Empting, 2009).Emotional distress, anxiety and depression, are also some of the neuropsychiatric symptoms frequent in special vulnerable populations, with particular need for help, such as in refugee populations. FB1 and ZEA levels were reported to be associated with drought stress in South Eastern Africa, sub-Saharan Africa, regions that host significant refugee populations (Yli-Mattila et al., 2022; Pestka, et al., 1987; Ren et al., 2016; Ren et al., 2016; Ratnaseelan et al., 2018). Although the number of studies on mycotoxin levels and their effects on health has rapidly increased in recent years, there is a lack of research and review articles in current literature databases regarding mycotoxin serum and urine levels in refugee populations worldwide. In this context, measuring the levels of mycotoxins in different refugees populations around the world, such as in Africa, Middle East, or Southeast Asia would be of great interest, not only for studying their effects on health, but especially in neuropsychiatric disorders. Considering the pivotal role of mycotoxins in the high levels of stunting in children, we believe it would be of great public health interest to study their levels in these vulnerable populations as well.We must also consider the numerous challenges, including the diversity of refugee populations, cultural contexts, national laws, and the lack of country-specific resources and data. It is also important to acknowledge the significant role of malnutrition, dietary deficiencies, psychological trauma, and post-traumatic stress disorder (PTSD) in contributing to neuropsychiatric symptoms in refugee populations. Deficiencies in vitamins (particularly vitamin B12), omega-3 fatty acids, and minerals, resulting from restricted access to adequate nutrition, are another contributing factor to neuropsychiatric symptoms in refugee populations, including mood disorders, anxiety, depression, and cognitive decline (Ogbu et al., 2020; Mason et al., 2012). In addition, many displaced individuals go through loss, violence, and experience an extreme emotional stress, or PTSD, which brings to manifestations of mental health disorders, including emotional instability, and social disengagement (Peconga et al., 2020). Thus, it is essential to consider how trauma, PTSD, and malnutrition, may intersect with the role of mycotoxin exposure in neuropsychiatric outcomes. Moreover, environmental pollutants like heavy metals (mercury, arsenic, lead) and pesticides may worsen neuropsychiatric symptoms in refugee populations, as they often live in areas with improper waste handling, and exposure to industrial pollutants that contaminate air, water, and food sources. The role of heavy metals in emotional disturbances, increased risk of depression and anxiety is widely acknowledged (Hughes, D., et al. 2020). On the other hand, in refugee populations, due to adjacency to farming activities, the exposure to pesticides combined with trauma and malnutrition, can exacerbate mental health issues (García, D., et al., 2020; Gupta et al., 2021; Terry et al., 2019). Adapting monitoring campaigns to identify the most efficient and cost-effective strategies for assessing and reducing mycotoxin exposure in refugee populations is crucial. Efforts such as improving food storage, diversifying diets, and utilizing biomarkers of exposure can significantly reduce mycotoxin-related risks. These measures are essential for reducing neuropsychiatric symptoms associated with mycotoxin exposure and alleviating the suffering of affected populations.Through this “opinion” study we propose an investigation of the levels of mycotoxins in these special populations, that will bring to further recommendations for the governmental and nongovernmental organizations, for either monitoring the prevalence of mycotoxins levels in neuropsychiatric symptoms in refugee populations, or for implementing various strategies to reduce mycotoxins exposure and contamination.
A Questionnaire-based Survey of the Suspected Adverse Reactions Reporting Associated with Dietary and Herbal Supplements by Pharmacists and Patients in Albania
Hedie Haxhiu, Malvina Hoxha, Bruno Zappacosta, Visar Malaj, Najada Firza
Universal Journal of Public Health, 2025
Background: Dietary and herbal supplements (DHS) have a widespread use in Albania, however, there is limited information on the reporting of their adverse effects by pharmacists and patients. This study aims to assess the reporting of suspected adverse reactions for dietary and herbal supplements by pharmacists and patients in Albania, as well as to evaluate the recurrence and occurrence of these reactions. Methods: A questionnaire-based survey was distributed online in Albania from January 2024 to March 2024 to patients and pharmacists with experience in direct patient care to evaluate their knowledge of the signaling of suspected adverse reactions of DHS. Results: A total of 113 pharmacists, and 159 patients in 9 and 12 different cities in Albania, respectively, consented to participate in the study. 69.91% of the pharmacists reported being informed about the necessity of reporting adverse effects associated with DHS during national conferences. However, only 8.85% have reported such effects to the responsible importers. Only 5.66% of patients have reported to their pharmacists about the adverse reactions of those products. Conclusions: The study highlights the need for improved education and training on reporting procedures for pharmacists and patients in Albania. By enhancing pharmacovigilance practices and promoting awareness among pharmacists and patients, we can lead toward a safer healthcare system in Albania.
Analysis of evidence on nutraceutical interventions for Peyronie’s disease: a guideline-based critical review
Daniele Tienforti, Malvina Hoxha, Alfonso Boris Di Pasquale, Vinicio Rizza, Arcangelo Barbonetti
Sexual Medicine Reviews, 2024
Introduction The management of Peyronie's disease (PD) is a challenge for the clinician. Despite the lack of etiologic therapy, different nonsurgical approaches have often been empirically proposed. The most used treatment is based on nutraceutical drugs with antioxidant activity, although such an intervention remains controversial. Objectives We reviewed the evidence from the randomized controlled trials included in the recommendations of the American Urological Association (AUA), Canadian Urological Association (CUA), European Association of Urology, and International Society for Sexual Medicine. Methods We searched PubMed, Scopus, Web of Science, and Cochrane Library for randomized controlled trials, reviews, and guidelines on nutraceutical interventions for PD. Results Our analysis provides detailed information on potential interventions, underlying the inconsistent evidence. Acetyl esters of carnitine, although not recommended by any of the available guidelines, showed potential benefit in some selected studies. Omega-3 fatty acids are not recommended due to withdrawn study evidence. The CUA and AUA were the only societies to consider the use of coenzyme Q10. While the CUA suggested that it might be offered as a treatment option, the AUA refrained from taking a definitive stance due to insufficient evidence. Similarly, conflicting recommendations have been produced on potassium para-aminobenzoate. While the CUA considers potassium para-aminobenzoate potentially useful in slowing PD progression, the AUA deems the evidence insufficient. Conversely, both the International Society for Sexual Medicine and European Association of Urology do not recommend its use. Conclusion This critical comparative analysis of the most recent guidelines produced by the leading scientific societies highlights some inconsistencies in the recommendations on nutraceutical intervention for PD, even within a background of overall ineffectiveness of this treatment approach.
Estimating the Prevalence of Cognitive Impairment and Its Associated Factors in Albania: A Nationwide Cross-Sectional Study
Malvina Hoxha, Simonetta Galgani, Jera Kruja, Ilir Alimehmeti, Viktor Rapo, Frenki Çipi, Domenico Tricarico, Bruno Zappacosta
Brain Sciences, 2024
Background/Objectives: Cognitive impairment is an intermediate state between normal aging and dementia, and its detection in the early stages is essential to prevent dementia, an incurable pathology. The aim of this study is to screen and estimate the prevalence of cognitive impairment, including dementia, and its correlated factors in a community-based sample of the Albanian population over 50 years old. Methods: We carried out a door-to-door neuropsychological screening of Albanian residents older than 50 years from November 2023 to June 2024 in 12 Albanian districts. Participants completed the Early Dementia Questionnaire (EDQ) and the Mini Mental State Examination (MMSE). Results: The overall estimating prevalence of cognitive impairment and early dementia among the Albanian population over 50 years old was 14.04% using the MMSE, with 2.31% for MMSE ≤18 (serious cognitive impairment), 5.51% for MMSE 19–22 (mild cognitive impairment (MCI)), and 6.22 for MMSE 23–24 (suspected cognitive impairment or dementia),respectively. The prevalence of early dementia using the EDQ was significantly higher (53.99%).The number of male participants with MMSE scores of 23–24 (suspected cognitive impairment or early dementia) was 2.5 times higher with respect to female participants. Smoking and alcohol consumption decreased the MMSE scores. The number of participants with normal cognitive function (MMSE scores 25–30) was lower among participants with hypertension, diabetes, hyperlipidemia, and cerebral ischemia. Conclusions: A diagnostic evaluation, including a clinical examination, neuroimaging, and laboratory studies, is further required for a diagnosis. Despite limitations, the data provided in this study are the only ones reported for a large community-based sample of the older adult Albanian population, which can help health care providers to diagnose cognitive impairment.
The Current State of Knowledge on Osteoporosis in Holocaust Survivors and Their Descendants
, Malvina Hoxha, Visar Malalj, and
Rambam Maimonides Medical Journal, 2024
Objective: Starvation in early life can cause poor bone health and metabolic aberrations in bone minerals, leading to abnormal bone development. Holocaust survivors have been exposed to starvation and malnutrition before and during World War II. This paper aims to provide the current state of knowledge on the osteoporosis risk in Holocaust survivors and their descendants. Methods: The PubMed and Scopus databases were searched. Papers that reported original data on the risk of osteoporosis in Holocaust survivors and in their offspring were included in the study. Results: Ten studies were included in this review. The majority of studies were case-control ones (n=7) versus two self-reported and one longitudinal study. Despite the limited cohort numbers and the small number of studies in the literature, the data showed a potential increased risk of osteoporosis in Holocaust survivors and especially in their descendants. Conclusions: The review of these studies showed a higher prevalence of osteoporosis among Holocaust survivors and their offspring. Knowledge of the trans-generational inheritance of osteoporosis in the descendants of Holocaust survivors should increase the awareness of primary care health workers on osteoporosis screening and early diagnosis and implementation of preventive measures, including adequate vitamin D and calcium supplementation, and pharmacological treatment.
Reporting of Adverse Drug Reactions by Dentists and Dental Patients in Albania
Malvina Hoxha, Erila Spahiu, Mishel Spahiu, Bruno Zappacosta
International Dental Journal, 2024
BACKGROUND: Procedures on reporting adverse drug reactions (ADRs) in Albania are not yet standardised with the European Union despite continuous legislative changes. The aim of this study was to assess for the first time in Albania the reporting of ADRs by dentists and dental patients and to evaluate the frequency and timing of ADRs. METHODS: We conducted a questionnaire-based survey for dentists and dental patients in Albania on their knowledge on ADR signalling. Dentists and their patients were randomly reached in private dental clinics. Ninety-five dentists and 640 dental patients from 5 different cities in Albania agreed to participate in the study. Only dentists who were actively working on their dental clinics and who volunteered to participate in the study were considered eligible. RESULTS: The response rates were 95.0% and 91.4% for dentists and dental patients, respectively. In addition, 7.36% of dentists reported to have been informed on the national ADR signalling through conferences, but when asked about the procedures only 28.6% of them reported to have knowledge on the concrete process. None of the dental patients knew how to report ADRs. CONCLUSIONS: The findings demonstrate the complete lack of information on ADR signalling in a randomly selected group of 640 dental patients and 95 dentists surveyed. The results of the study are concerning and show that knowledge on ADR signalling should massively increase through public and social media.
Health Economic Evaluations of Hemochromatosis Screening and Treatment: A Systematic Review
Malvina Hoxha, Visar Malaj, Bruno Zappacosta
Pharmacoeconomics Open, 2024
Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening
Malvina Hoxha, Visar Malaj, Bruno Zappacosta, Najada Firza
Clinicoeconomics and Outcomes Research, 2024
Arachidonic Acid Pathways and Male Fertility: A Systematic Review
Malvina Hoxha, Arcangelo Barbonetti, Bruno Zappacosta
International Journal of Molecular Sciences, 2023
Meteoropathy: a review on the current state of knowledge
Malvina Hoxha, , Bruno Zappacosta, and
Journal of Medicine and Life, 2023
Anxiety and depression in geriatric hemodialysis patients: factors that influence the border of diseases
Brunilda Elezi, Erjona Abazaj, Bruno Zappacosta, Malvina Hoxha
Frontiers in Psychology, 2023
A review on the role of fatty acids in colorectal cancer progression
Malvina Hoxha, Bruno Zappacosta
Frontiers in Pharmacology, 2022
Compatibility of prolonged infusion antibiotics during Y-site administration
María Nunez‐Nunez, Manuel Murillo‐Izquierdo, Marisa Moya‐Martin, Malvina Hoxha, M. Teresa Quesada Pérez, Fernando Oltra‐Hostalet, Hector Alonso‐Ramos, Jaime Cordero‐Ramos, Jose Barrera‐Cabeza, Pilar Retamar‐Gentil, Santiago Sandoval Fernández‐del‐Castillo
Nursing in Critical Care, 2022
The Importance of Nutraceuticals in COVID-19: What’s the Role of Resveratrol?
Elisa Domi, Malvina Hoxha, Entela Kolovani, Domenico Tricarico, Bruno Zappacosta
Molecules, 2022
Arachidonic Acid Mediators and their Role in Neurological Disease
Malvina Hoxha
CNS and Neurological Disorders Drug Targets, 2022
A Systematic Review on the Role of Arachidonic Acid Pathway in Multiple Sclerosis
Malvina Hoxha, Erila Spahiu, Emanuela Prendi, Bruno Zappacosta
CNS and Neurological Disorders Drug Targets, 2022
ATP-sensitive Potassium Channel Subunits in Neuroinflammation: Novel Drug Targets in Neurodegenerative Disorders
Fatima Maqoud, Rosa Scala, Malvina Hoxha, Bruno Zappacosta, Domenico Tricarico
CNS and Neurological Disorders Drug Targets, 2022
Folic acid and autism: A systematic review of the current state of knowledge
Bianka Hoxha, Malvina Hoxha, Elisa Domi, Jacopo Gervasoni, Silvia Persichilli, Visar Malaj, Bruno Zappacosta
Cells, 2021
A systematic review on the role of sirt1 in duchenne muscular dystrophy
Elisa Domi, Malvina Hoxha, Emanuela Prendi, Bruno Zappacosta
Cells, 2021
Montelukast Use Decreases Cardiovascular Events in Asthmatics
Malvina Hoxha, Calogero C. Tedesco, Silvana Quaglin, Visar Malaj, Linda Pustina, Valerie Capra, Jilly F. Evans, Angelo Sala, G. Enrico Rovati
Frontiers in Pharmacology, 2021
The interaction between arachidonic acid metabolism and homocysteine
Elisa Domi, Malvina Hoxha, Bianka Hoxha, Bruno Zappacosta
Endocrine Metabolic and Immune Disorders Drug Targets, 2021
A case–control study: Evaluating the role of leukotriene receptor antagonists in preventing the cardiovascular and cerebrovascular disease
M. Hoxha, V. Malaj, M. Vara-Messler, C.R. Doce, A.B. Cavanillas
Semergen, 2021
What about COVID-19 and arachidonic acid pathway?
Malvina Hoxha
European Journal of Clinical Pharmacology, 2020
CYP-derived eicosanoids: Implications for rheumatoid arthritis
Malvina Hoxha, Bruno Zappacosta
Prostaglandins and Other Lipid Mediators, 2020
Dentists knowledge about over the counter-NSAIDs: An emerging need for NSAID-avoidance education
M. Hoxha, V. Malaj, Erila Spahiu, Mishel Spahiu
Journal of Applied Pharmaceutical Science, 2020
Duchenne muscular dystrophy: Focus on arachidonic acid metabolites
Malvina Hoxha
Biomedicine and Pharmacotherapy, 2019
New frontiers for the treatment of atherosclerosis: PCSK9
Giornale Italiano Di Farmacia Clinica, 2018
Potential role of leukotriene receptor antagonists in reducing cardiovascular and cerbrovascular risk: A systematic review of human clinical trials and in vivo animal studies
Malvina Hoxha, Anne-Mary Lewis-Mikhael, Aurora Bueno-Cavanillas
Biomedicine and Pharmacotherapy, 2018
A systematic review on the role of eicosanoid pathways in rheumatoid arthritis
Malvina Hoxha
Advances in Medical Sciences, 2018
The leukotriene receptor antagonist montelukast and its possible role in the cardiovascular field
Malvina Hoxha, G. Enrico Rovati, Aurora Bueno Cavanillas
European Journal of Clinical Pharmacology, 2017
In vitro pharmacological evaluation of multitarget agents for thromboxane prostanoid receptor antagonism and COX-2 inhibition
Malvina Hoxha, Carola Buccellati, Valérie Capra, Davide Garella, Clara Cena, Barbara Rolando, Roberta Fruttero, Silvia Carnevali, Angelo Sala, G.Enrico Rovati, Massimo Bertinaria
Pharmacological Research, 2016
A potential role of PUFAs and COXIBs in cancer chemoprevention
Marianela Vara-Messler, Carola Buccellati, Linda Pustina, Giancarlo Folco, G. Enrico Rovati, Malvina Hoxha
Prostaglandins and Other Lipid Mediators, 2015
Corrigendum: Designing Multitarget Anti-inflammatory Agents: Chemical Modulation of the Lumiracoxib Structure toward Dual Thromboxane Antagonists-COX-2 Inhibitors
Massimo Bertinaria, Mohammed Abrar Abdul Gaffar Shaikh, Carola Buccellati, Clara Cena, Barbara Rolando, Loretta Lazzarato, Roberta Fruttero, Alberto Gasco, Malvina Hoxha, Valérie Capra, Angelo Sala, G. Enrico Rovati
Chemmedchem, 2012
Designing Multitarget Anti-inflammatory Agents: Chemical Modulation of the Lumiracoxib Structure toward Dual Thromboxane Antagonists-COX-2 Inhibitors
Massimo Bertinaria, Mohammed Abrar Abdul Gaffar Shaikh, Carola Buccellati, Clara Cena, Barbara Rolando, Loretta Lazzarato, Roberta Fruttero, Alberto Gasco, Malvina Hoxha, Valérie Capra, Angelo Sala, G. Enrico Rovati
Chemmedchem, 2012

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