scholarly journals Children’s Pain: A Mandate for Change

2001 ◽  
Vol 6 (1) ◽  
pp. 29-39 ◽  
Author(s):  
Andrea L Brennan-Hunter
Keyword(s):  
Current Knowledge ◽  
Clinical Care ◽  
Treatment Strategies ◽  
Medline Search ◽  
The Past ◽  
Key Word ◽  
Different Types ◽  
Pain Knowledge ◽  
Children's Pain ◽  
Effective Assessment

There have been tremendous research advances in the past 15 years in knowledge about children's pain, and strategies for recognizing and managing that pain. However, the clinical care of children in pain remains a challenge. Children's pain continues to be frequently unrecognized , dismissed or ineffectively managed. A loud call for change is being voiced by physicians, nurses, children and their families. A review of the literature was conducted to document this issue. Starting with a Medline search of the key word 'child* + pain' and continuing with a snowball technique, articles and resources addressing children's pain were collected. Resources presented or published after 1990 were particularly sought because they theoretically reflect both current knowledge about children's pain and the implementation of this knowledge in practice. Unfortunately, although information on pain is available to help children, in many instances, it is not being used. The purpose of the present paper is twofold -- to present an overview of current knowledge of children's pain, and factors that hinder its effective assessment and management; and to present a mandate for change. Children's postoperative pain is highlighted in this paper as an example of the gap between pain knowledge and clinical practice. Although treatment strategies differ across different types of pain, children's conditions and ages, the principles and mandate for change discussed in this paper are directly relevant to all categories of children's pain.

scholarly journals Liver Fibrosis: Causes and Methods of Assessment, A Review

2015 ◽  
Vol 53 (4) ◽  
pp. 304-314 ◽  
Author(s):  
Ali Erfani Karimzadeh Toosi
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Hepatic Dysfunction ◽  
Current Knowledge ◽  
Treatment Strategies ◽  
Future Research ◽  
Progressive Development ◽  
Non Invasive ◽  
The Past ◽  
Invasive Method

AbstractHepatic fibrogenesis is the final result of injury to the liver. Fibrosis could lead to hepatic dysfunction, important in the pathogenesis of other chronic problems. Therefore, understanding the mechanism, accurate diagnosis and staging of it in early stages accelerates the treatment and reduces the prevalence of chirrosis. Treatment strategies of liver problems and detction methods depend on the amount and progression of liver fibrosis and the rate of cirrhosis development. Traditionally the invasive method, liver biopsy, is reference standard to follow progression and stage of fibrosis. However, during the past decade, progressive development of novel non-invasive methodologies has challenged the invasive method. Non-invasive methods have been initially introduced for chronic hepatitis C with increasing use in other chronic liver diseases. The need for liver biopsy has nowadays decreased significantly as a result of these methodologies. Most of the new non-invasive methods depend on either ‘biological’ or ‘physical’ approaches.In this review, starting from the mechanism of fibrogenesis, the current knowledge about diagnosis, treatment strategies and different methods for its evaluation is discussed. This is followed by a conclusion on what is expected to be known in this field during the future research.

scholarly journals Pharmacological and Parenteral Nutrition-Based Interventions in Microvillus Inclusion Disease

2020 ◽  
Vol 10 (1) ◽  
pp. 22
Author(s):  
Changsen Leng ◽  
Edmond H. H. M. Rings ◽  
Saskia N. de Wildt ◽  
Sven C. D. van IJzendoorn
Keyword(s):  
Parenteral Nutrition ◽  
Clinical Research ◽  
Alternative Treatment ◽  
Current Knowledge ◽  
Case Reports ◽  
Clinical Care ◽  
Treatment Strategies ◽  
Secretory Diarrhea ◽  
Pharmacological Interventions ◽  
Recent Advances

Microvillus inclusion disease (MVID) is a rare inherited and invariably fatal enteropathy, characterized by severe intractable secretory diarrhea and nutrient malabsorption. No cure exists, and patients typically die during infancy because of treatment-related complications. The need for alternative treatment strategies is evident. Several pharmacological interventions with variable successes have been tried and reported for individual patients as part of their clinical care. Unfortunately, these interventions and their outcomes have remained hidden in case reports and have not been reviewed. Further, recent advances regarding MVID pathogenesis have shed new light on the outcomes of these pharmacological interventions and offer suggestions for future clinical research and trials. Hence, an inventory of reported pharmacological interventions in MVID, their rationales and outcomes, and a discussion of these in the light of current knowledge is opportune. Together with a discussion on MVID-specific pharmacokinetic, -dynamic, and -genetic concerns that pose unique challenges regarding pharmacological strategies, we envision that this paper will aid researchers and clinicians in their efforts to develop pharmacological interventions to combat this devastating disease.

scholarly journals Febrile Seizures and Febrile Seizure Syndromes: An Updated Overview of Old and Current Knowledge

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Abdulhafeez M. Khair ◽  
Dalal Elmagrabi
Keyword(s):  
Febrile Seizure ◽  
Current Knowledge ◽  
Treatment Strategies ◽  
Febrile Seizures ◽  
Clinical Aspects ◽  
Human Knowledge ◽  
The Past ◽  
Sources Of Knowledge ◽  
Family Distress ◽  
Over Time

Febrile seizures are the most common paroxysmal episode during childhood, affecting up to one in 10 children. They are a major cause of emergency facility visits and a source of family distress and anxiety. Their etiology and pathophysiological pathways are being understood better over time; however, there is still more to learn. Genetic predisposition is thought to be a major contributor. Febrile seizures have been historically classified as benign; however, many emerging febrile seizure syndromes behave differently. The way in which human knowledge has evolved over the years in regard to febrile seizures has not been dealt with in depth in the current literature, up to our current knowledge. This review serves as a documentary of how scientists have explored febrile seizures, elaborating on the journey of knowledge as far as etiology, clinical features, approach, and treatment strategies are concerned. Although this review cannot cover all clinical aspects related to febrile seizures at the textbook level, we believe it can function as a quick summary of the past and current sources of knowledge for all varieties of febrile seizure types and syndromes.

scholarly journals How I treat CNS lymphomas

Blood ◽  
2013 ◽  
Vol 122 (14) ◽  
pp. 2318-2330 ◽  
Author(s):  
James L. Rubenstein ◽  
Neel K. Gupta ◽  
Gabriel N. Mannis ◽  
Amanda K. LaMarre ◽  
Patrick Treseler
Keyword(s):  
Current Knowledge ◽  
Treatment Strategies ◽  
Cns Lymphoma ◽  
Clinical Neuropsychology ◽  
Term Survival ◽  
The Past ◽  
Dismal Prognosis ◽  
Novel Treatment Strategies ◽  
Cns Lymphomas

Abstract The pathogenesis of primary and secondary central nervous system (CNS) lymphoma poses a unique set of diagnostic, prognostic, and therapeutic challenges. During the past 10 years, there has been significant progress in the elucidation of the molecular properties of CNS lymphomas and their microenvironment, as well as evolution in the development of novel treatment strategies. Although a CNS lymphoma diagnosis was once assumed to be uniformly associated with a dismal prognosis, it is now reasonable to anticipate long-term survival, and possibly a cure, for a significant fraction of CNS lymphoma patients. The pathogenesis of CNS lymphomas affects multiple compartments within the neuroaxis, and proper treatment of the CNS lymphoma patient requires a multidisciplinary team with expertise not only in hematology/oncology but also in neurology, neuroradiology, neurosurgery, clinical neuropsychology, ophthalmology, pathology, and radiation oncology. Given the evolving principles of management and the evidence for improvements in survival, our goal is to provide an overview of current knowledge regarding the pathogenesis of CNS lymphomas and to highlight promising strategies that we believe to be most effective in establishing diagnosis, staging, and therapeutic management.

Invited Review: Effect of oxygen deprivation on cell cycle activity: a profile of delay and arrest

2003 ◽  
Vol 94 (5) ◽  
pp. 2068-2083 ◽  
Author(s):  
R. M. Douglas ◽  
G. G. Haddad
Keyword(s):  
Cell Cycle ◽  
Early Life ◽  
Current Knowledge ◽  
Clinical Care ◽  
Treatment Strategies ◽  
Point Of View ◽  
Cell Cycles ◽  
Young Embryo ◽  
Dividing Cells ◽  
Effect Of Oxygen

One of the most fascinating fields that have emanated in the past few decades is developmental biology. This is not only the case from a research point of view but also from the angle of clinical care and treatment strategies. It is now well demonstrated that there are many diseases (some believe all diseases) that have their roots in embryogenesis or in early life, where nature and environment often team up to facilitate the genesis of disease. There is probably no better example to illustrate the interactions between nature and environment than in early life, as early as in the first several cell cycles. As will be apparent in this review, the cell cycle is a very regulated activity and this regulation is genetic in nature, with checkpoint proteins playing an important role in controlling the timing, the size, and the growth of daughter cells. However, it is also very clear, as will be discussed in this work, that the microenvironment of the first dividing cells is so important for the outcome of the organism. In this review, we will focus on the effect of one stress, that of hypoxia, on the young embryo and its cell division and growth. We will first review some of the cell cycle definitions and stages and then review briefly our current knowledge and its gaps in this area.

scholarly journals Provisional Tic Disorder: What to tell parents when their child first starts ticcing

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 696 ◽  
Author(s):  
Kevin J Black ◽  
Elizabeth Rose Black ◽  
Deanna J. Greene ◽  
Bradley L. Schlaggar
Keyword(s):  
Clinical Care ◽  
Treatment Strategies ◽  
Spontaneous Remission ◽  
Tic Disorders ◽  
Tic Disorder ◽  
Recent Onset ◽  
The Past ◽  
Novel Treatment ◽  
Novel Treatment Strategies ◽  
Existing Data

The child with recent onset of tics is a common patient in a pediatrics or child neurology practice. If the child’s first tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions.PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of tics. A better understanding of tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of tic disorders.This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that tic disorders may completely remit much less often than is generally believed.

Study of the Molecular Architecture of Keratin Filaments by Electron Microscopy

1982 ◽  
Vol 40 ◽  
pp. 118-119
Author(s):  
U. Aebi ◽  
P. Rew ◽  
T.-T. Sun
Keyword(s):  
Electron Microscopy ◽  
Structural Organization ◽  
Cell Types ◽  
Structural Features ◽  
Molecular Architecture ◽  
The Past ◽  
Keratin Filaments ◽  
Different Types ◽  
10 Nm Filaments ◽  
Different Cell Types

Various types of intermediate-sized (10-nm) filaments have been found and described in many different cell types during the past few years. Despite the differences in the chemical composition among the different types of filaments, they all yield common structural features: they are usually up to several microns long and have a diameter of 7 to 10 nm; there is evidence that they are made of several 2 to 3.5 nm wide protofilaments which are helically wound around each other; the secondary structure of the polypeptides constituting the filaments is rich in ∞-helix. However a detailed description of their structural organization is lacking to date.

Novel Drugs and Biologics of 2016: A Boom for Neurodrugs in the Pipelin

2017 ◽  
Vol 10 (5) ◽  
pp. 3809-3814
Author(s):  
D Samba Reddy
Keyword(s):  
Muscular Atrophy ◽  
Clinical Care ◽  
New Drugs ◽  
Essential Medicines ◽  
High Demand ◽  
The Past ◽  
Novel Drugs ◽  
Innovative Products ◽  
Cns Drugs ◽  
The U.S

This article provides a brief overview of novel drugs approved by the U.S. FDA in 2016.  It also focuses on the emerging boom in the development of neurodrugs for central nervous system (CNS) disorders. These new drugs are innovative products that often help advance clinical care worldwide, and in 2016, twenty-two such drugs were approved by the FDA. The list includes the first new drug for disorders such as spinal muscular atrophy, Duchenne muscular dystrophy or hallucinations and delusions of Parkinson’s disease, among several others. Notably, nine of twenty-two (40%) were novel CNS drugs, indicating the industry shifting to neurodrugs. Neurodrugs are the top selling pharmaceuticals worldwide, especially in America and Europe. Therapeutic neurodrugs have proven their significance many times in the past few decades, and the CNS drug portfolio represents some of the most valuable agents in the current pipeline. Many neuroproducts are vital or essential medicines in the current therapeutic armamentarium, including dozens of “blockbuster drugs” (drugs with $1 billion sales potential).  These drugs include antidepressants, antimigraine medications, and anti-epilepsy medications. The rise in neurodrugs’ sales is predominantly due to increased diagnoses of CNS conditions. The boom for neuromedicines is evident from the recent rise in investment, production, and introduction of new CNS drugs.  There are many promising neurodrugs still in the pipeline, which are developed based on the validated “mechanism-based” strategy. Overall, disease-modifying neurodrugs that can prevent or cure serious diseases, such as multiple sclerosis, epilepsy, and Alzheimer’s disease, are in high demand. 

Recent Nanocarrier Approaches for Targeted Drug Delivery in Cancer Therapy

2020 ◽  
Vol 13 ◽  
Author(s):  
Rohit Bhatia ◽  
Amit Sharma ◽  
Raj Kumar Narang ◽  
Ravindra K. Rawal
Keyword(s):  
Drug Delivery ◽  
Polymeric Micelles ◽  
Mesoporous Silica Nanoparticles ◽  
Treatment Strategies ◽  
Human Beings ◽  
The Past ◽  
Organ Systems ◽  
Metal Organic ◽  
Continuous Progress ◽  
Chemotherapeutic Treatment

: Cancer is one of the most serious health concerns in 21st century whose prevalence is beyond boundaries and can affect any organ of human beings. The conventional chemotherapeutic treatment strategies lack specificity to tumours and are associated with toxic effects on immune system and other organ systems. In the past decades, there has been a continuous progress in the development of smart nanocarrier systems for target specific delivery of drugs against variety of tumours including intracellular gene-specific targeting. These nanocarriers are able to recognize the tumour cells and deliver the therapeutic agent in fixed proportions causing no or very less harm to healthy cells. Nanosystems have modified physicochemical properties, improved bioavailability and long retention in blood which enhances their potency. A huge number of nanocarrier based formulations have been developed and are in clinical trials. Nanocarrier systems include polymeric micelles, liposomes, dendrimers, carbon nanotubes, gold nanoparticles, etc. Recent advancements in nanocarrier systems include mesoporous silica nanoparticles (MSNs), metal organic frame works and quantum dots. In the present review, various nanocarrier based drug delivery systems along with their applications in the management of cancer have been described with special emphasis on MSNs.

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