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 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 Second Line Treatment Strategies in Multiple Myeloma: A Referral-Center Experience

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 819-819
Author(s):  
Sarah Goldman-Mazur ◽  
Alissa Visram ◽  
S Vincent Rajkumar ◽  
Prashant Kapoor ◽  
Angela Dispenzieri ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Board Of Directors ◽  
Research Funding ◽  
Alkylating Agents ◽  
Treatment Strategies ◽  
Line Treatment ◽  
Advisory Committees ◽  
The Past ◽  
Line Therapy ◽  
Over Time

Abstract Background Recommendations for 2 nd line treatment for relapsed multiple myeloma (MM) patients have been changing over the past two decades, given the introduction of novel agents, different side-effect profiles, and attempts at more individualized treatment approaches. We designed this study to characterize how 2 nd line treatment strategies have evolved over the last two decades for MM patients. Methods Patients with MM with at least one relapse treated with a 2 nd line regimen, seen at Mayo Clinic between 2003-2021, were included. To visualize trends in treatment choices we divided the study period into 2-year intervals and for descriptive purpose the period was divided into three 6-year intervals. We used "100% stacked area" charts to show how the constituent parts of the whole have changed over time. The height of each colored stack represents the proportion of patients in that category at a given point in time. Results A total of 1439 patients were included. Patients were diagnosed between 2001 and 2018, the initiation of 2 nd line treatment occurred between June 2003 and February 2021. Median age at diagnosis was 62.7 years (interquartile range, 55.8-69.3), 60.0% were male. International Staging System stage I was present in 23.5% of patients, stage II in 32.9% and stage III in 28.8%. In the 1 st line therapy novel agents were used in 82.8% of cases, regimens based on proteasome inhibitors (PI) in 26.5%, immunomodulatory drugs (IMID) in 42.0% and combination of PI+IMID in 21.1%. Upfront autologous stem cell transplantation (ASCT) was performed in 50.1% of patients, and maintenance after 1 st line was used in 25.2%. For 2 nd line treatment, during 2003-2008 the majority were treated with doublets (70.5%), followed by triplets (14.8%) and salvage ASCT (7.7%) (Figure 1A). Patients were treated with IMID or PI-based therapy (50.7% and 21.8%, respectively); only 3.7% received PI+IMID and 20.1% of patients received alkylating agents/anthracyclines. The most frequently used regimens were lenalidomide-dexamethasone (RD, 32.2%) and bortezomib-dexamethasone (VD, 18.1%, Figure 1B). Between 2009-2014, the use of triplets in 2 nd line increased (43.0%), although doublets were still more common (50.9%). Like previous years, IMID-based therapy was most frequently used (37.3%), however, the use of PI-based therapy increased (36.0%). PI+IMID-based therapy was implemented in 17.9% of patient, and 27.3% received alkylating agents/anthracyclines. Most frequently used regimens included: RD (29.4%), bortezomib-cyclophosphamide-dexamethasone (CYBORD, 17.4%), bortezomib-lenalidomide-dexamethasone (VRD, 13.4%) and VD (13.3%). Finally, during 2015-2021, triplets were most common (68.9%), followed by doublets (23.0%). IMID- and PI+IMID-based therapies were most often implemented (34.2% and 31.1%, respectively), followed by PI-based therapy (26.8%). 28.1% of patients received monoclonal antibodies; only 15.9% received alkylating agents/anthracyclines. Most frequently used regimens include RD (13.8%), carfilzomib-RD (11.6%), daratumumab-RD (9.8%), CYBORD (9.3%), VRD (8.8%), daratumumab-pomalidomide-dexamethasone (5.9%) and daratumumab-VD (5.2%). Median time to next treatment (TTNT) from 2 nd line therapy has improved over the course of the three time periods (p<0.01; Figure 1C): years 2003-2008, 10.4 months; years 2009-2014, 13.2 months; and years 2014-2021, 16.6 months. Similarly, the median overall survival from 1 st relapse has increased over the three intervals: 30.9 months, 48.4 months, and 65.8 months, respectively. Conclusions Over the past two decades, the effectiveness of 2 nd line treatment has improved, reflected by improved TTNT from 2 nd line therapy. With the introduction of new agents in 2012-2015 (carfilzomib, pomalidomide and daratumumab) and favorable results for triplets demonstrated in randomized trials, the triplet therapies started to be used more frequently. Over time, the landscape of 2 nd line therapies has become more diverse, which may reflect a more individualized approach to each patient. Moreover, the large variety of treatment strategies makes comparisons more and more challenging. Figure 1 Figure 1. Disclosures Kapoor: Ichnos Sciences: Research Funding; Karyopharm: Consultancy; BeiGene: Consultancy; Pharmacyclics: Consultancy; Sanofi: Consultancy; Amgen: Research Funding; Cellectar: Consultancy; Regeneron Pharmaceuticals: Research Funding; Glaxo SmithKline: Research Funding; Karyopharm: Research Funding; Sanofi: Research Funding; Takeda: Research Funding; AbbVie: Research Funding. Dispenzieri: Pfizer: Research Funding; Alnylam: Research Funding; Takeda: Research Funding; Oncopeptides: Consultancy; Sorrento Therapeutics: Consultancy; Janssen: Consultancy, Research Funding. Gertz: Akcea Therapeutics, Ambry Genetics, Amgen Inc, Celgene Corporation, Janssen Biotech Inc, Karyopharm Therapeutics, Pfizer Inc (to Institution), Sanofi Genzyme: Honoraria; Aurora Biopharma: Other: Stock option; Akcea Therapeutics, Alnylam Pharmaceuticals Inc, Prothena: Consultancy; AbbVie Inc, Celgene Corporation: Other: Data Safetly & Monitoring; Ionis Pharmaceuticals: Other: Advisory Board. Dingli: Sanofi: Consultancy; Apellis: Consultancy; Novartis: Research Funding; Alexion: Consultancy; Janssen: Consultancy; GSK: Consultancy. Kumar: Adaptive: Membership on an entity's Board of Directors or advisory committees, Research Funding; Bluebird Bio: Consultancy; Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Tenebio: Research Funding; Carsgen: Research Funding; Beigene: Consultancy; Antengene: Consultancy, Honoraria; Roche-Genentech: Consultancy, Research Funding; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Astra-Zeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Merck: Research Funding; Novartis: Research Funding; Sanofi: Research Funding; KITE: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Oncopeptides: Consultancy.

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 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.

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.

Introduction

2018 ◽  
Author(s):  
Telesca Giuseppe
Keyword(s):  
Structural Analysis ◽  
Institutional Change ◽  
Cultural Context ◽  
The Past ◽  
Final Goal ◽  
Social Structural ◽  
Country Analysis ◽  
Cross Country ◽  
Over Time

The ambition of this book is to combine different bodies of scholarship that in the past have been interested in (1) providing social/structural analysis of financial elites, (2) measuring their influence, or (3) exploring their degree of persistence/circulation. The final goal of the volume is to investigate the adjustment of financial elites to institutional change, and to assess financial elites’ contribution to institutional change. To reach this goal, the nine chapters of the book introduced here look at financial elites’ role in different European societies and markets over time, and provide historical comparisons and country and cross-country analysis of their adaptation and contribution to the transformation of the national and international regulatory/cultural context in the wake of a crisis or in a longer term perspective.

Newman's Early Roman Catholic Legacy, 1845-1854

2017 ◽  
Author(s):  
C. Michael Shea
Keyword(s):  
Nineteenth Century ◽  
Catholic Church ◽  
Roman Catholic ◽  
Roman Catholic Church ◽  
John Henry Newman ◽  
Christian Doctrine ◽  
European Continent ◽  
The Past ◽  
Immaculate Conception ◽  
Over Time

For the past several decades, scholars have stressed that the genius of John Henry Newman remained underappreciated among his Roman Catholic contemporaries, and in order to find the true impact of his work, one must look to the century after his death. This book takes direct aim at that assumption. Examining a host of overlooked evidence from England and the European continent, Newman’s Early Legacy tracks letters, recorded conversations, and obscure and unpublished theological exchanges to show how Newman’s 1845 Essay on the Development of Christian Doctrine influenced a cadre of Catholic teachers, writers, and Church authorities in nineteenth-century Rome. The book explores how these individuals then employed Newman’s theory of development to argue for the definability of the new dogma of the Immaculate Conception of Mary during the years preceding the doctrine’s promulgation in 1854. Through numerous twists and turns, the narrative traces how the theory of development became a factor in determining the very language that the Roman Catholic Church would use in referring to doctrinal change over time. In this way, Newman’s Early Legacy uncovers a key dimension of Newman’s significance in modern religious history.

Introduction

2018 ◽  
Author(s):  
Stephanie Downes ◽  
Sally Holloway ◽  
Sarah Randles
Keyword(s):  
Material World ◽  
The Past ◽  
Over Time

This book is about the ways in which humans have been bound affectively to the material world in and over time; how they have made, commissioned, and used objects to facilitate their emotional lives; how they felt about their things; and the ways certain things from the past continue to make people feel today. The temporal and geographical focus of ...

Anti-corruption in History

2017 ◽  
Keyword(s):  
Financial Institutions ◽  
Global Media ◽  
Policy Makers ◽  
The Past ◽  
Human Wellbeing ◽  
Modern Period ◽  
Legitimate Power ◽  
Wide Range ◽  
Scant Attention ◽  
Over Time

Anticorruption in History is the first major collection of case studies on how past societies and polities, in and beyond Europe, defined legitimate power in terms of fighting corruption and designed specific mechanisms to pursue that agenda. It is a timely book: corruption is widely seen today as a major problem, undermining trust in government, financial institutions, economic efficiency, the principle of equality before the law and human wellbeing in general. Corruption, in short, is a major hurdle on the “path to Denmark”—a feted blueprint for stable and successful statebuilding. The resonance of this view explains why efforts to promote anticorruption policies have proliferated in recent years. But while the subjects of corruption and anticorruption have captured the attention of politicians, scholars, NGOs and the global media, scant attention has been paid to the link between corruption and the change of anticorruption policies over time and place. Such a historical approach could help explain major moments of change in the past as well as reasons for the success and failure of specific anticorruption policies and their relation to a country’s image (of itself or as construed from outside) as being more or less corrupt. It is precisely this scholarly lacuna that the present volume intends to begin to fill. A wide range of historical contexts are addressed, ranging from the ancient to the modern period, with specific insights for policy makers offered throughout.

scholarly journals Clinician-Reported Patient Awareness of Symptoms and Severity of Tardive Dyskinesia in Patients Prescribed VMAT2 Inhibitors

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 151-151
Author(s):  
Jonathan M. Meyer ◽  
Ericha Franey ◽  
Leslie Lundt ◽  
Betsy Benning ◽  
Edward Goldberg ◽  
...  
Keyword(s):  
Tardive Dyskinesia ◽  
Symptom Severity ◽  
Primary Care Physicians ◽  
Additional Data ◽  
Treatment Strategies ◽  
Vesicular Monoamine Transporter ◽  
Patient Awareness ◽  
Patient Demographics ◽  
The Past ◽  
Body Regions

AbstractObjectiveVesicular monoamine transporter 2 (VMAT2) inhibitors including valbenazine are first-line therapies for tardive dyskinesia (TD), a persistent movement disorder associated with antipsychotic exposure. This real-world study was performed to assess the association between patient awareness of TD symptoms and clinician-assessed symptom severity.MethodsClinicians who treated antipsychotic-induced TD with a VMAT2 inhibitor within the past 24 months were asked to extract demographic/clinical data from patients charts and complete a survey for additional data, including patient awareness of TD (yes/no) and TD symptom severity (mild/moderate/severe).ResultsData for 601 patients were provided by 163 clinicians (113 psychiatrists; 46 neurologists; 4 primary care physicians). Patient demographics: 50% male; mean age 50.6 years; 55% schizophrenia/schizoaffective disorder; 29% bipolar disorder; 16% other psychiatric diagnoses. Positive relationships were seen between patient awareness and clinician-assessed symptom severity. Awareness was highest in patients with severe symptoms in specific body regions: face (88% vs 78%/69% [awareness by severe vs moderate/mild symptoms]); jaw (90% vs 80%/67%); wrists (90% vs 69%/63%). In other regions, awareness was similar in patients with severe or moderate symptoms: lips (85%/86% vs 68% [severe/moderate vs mild]); tongue (81%/80% vs 73%); neck (80%/78% vs 68%); arms (67%/66% vs 62%); knees (67%/67% vs 53%).ConclusionsIn patients prescribed a VMAT2 inhibitor for TD, patient awareness was generally higher in those determined to have moderate-to-severe symptom severity as assessed by the clinician. More research is needed to understand how awareness and severity contribute to TD burden, and whether different treatment strategies are needed based on these factors.FundingNeurocrine Biosciences, Inc.

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