scholarly journals Improving Newborn Respiratory Outcomes With a Sustained Inflation: A Systematic Narrative Review of Factors Regulating Outcome in Animal and Clinical Studies

2020 ◽  
Vol 8 ◽  
Author(s):  
Calista J. Lambert ◽  
Stuart B. Hooper ◽  
Arjan B. te Pas ◽  
Erin V. McGillick
Keyword(s):  
Clinical Studies ◽  
Narrative Review ◽  
Sustained Inflation ◽  
Respiratory Outcomes

scholarly journals Topical Treatments and Their Molecular/Cellular Mechanisms in Patients with Peripheral Neuropathic Pain—Narrative Review

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 450
Author(s):  
Magdalena Kocot-Kępska ◽  
Renata Zajączkowska ◽  
Joanna Mika ◽  
David J. Kopsky ◽  
Jerzy Wordliczek ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Pain Management ◽  
Clinical Studies ◽  
Neuronal Cells ◽  
Case Series ◽  
Narrative Review ◽  
Peripheral Sensitization ◽  
Cellular Mechanisms ◽  
Peripheral Neuropathic Pain ◽  
Topical Treatments

Neuropathic pain in humans results from an injury or disease of the somatosensory nervous system at the peripheral or central level. Despite the considerable progress in pain management methods made to date, peripheral neuropathic pain significantly impacts patients’ quality of life, as pharmacological and non-pharmacological methods often fail or induce side effects. Topical treatments are gaining popularity in the management of peripheral neuropathic pain, due to excellent safety profiles and preferences. Moreover, topical treatments applied locally may target the underlying mechanisms of peripheral sensitization and pain. Recent studies showed that peripheral sensitization results from interactions between neuronal and non-neuronal cells, with numerous signaling molecules and molecular/cellular targets involved. This narrative review discusses the molecular/cellular mechanisms of drugs available in topical formulations utilized in clinical practice and their effectiveness in clinical studies in patients with peripheral neuropathic pain. We searched PubMed for papers published from 1 January 1995 to 30 November 2020. The key search phrases for identifying potentially relevant articles were “topical AND pain”, “topical AND neuropathic”, “topical AND treatment”, “topical AND mechanism”, “peripheral neuropathic”, and “mechanism”. The result of our search was 23 randomized controlled trials (RCT), 9 open-label studies, 16 retrospective studies, 20 case (series) reports, 8 systematic reviews, 66 narrative reviews, and 140 experimental studies. The data from preclinical studies revealed that active compounds of topical treatments exert multiple mechanisms of action, directly or indirectly modulating ion channels, receptors, proteins, and enzymes expressed by neuronal and non-neuronal cells, and thus contributing to antinociception. However, which mechanisms and the extent to which the mechanisms contribute to pain relief observed in humans remain unclear. The evidence from RCTs and reviews supports 5% lidocaine patches, 8% capsaicin patches, and botulinum toxin A injections as effective treatments in patients with peripheral neuropathic pain. In turn, single RCTs support evidence of doxepin, funapide, diclofenac, baclofen, clonidine, loperamide, and cannabidiol in neuropathic pain states. Topical administration of phenytoin, ambroxol, and prazosin is supported by observational clinical studies. For topical amitriptyline, menthol, and gabapentin, evidence comes from case reports and case series. For topical ketamine and baclofen, data supporting their effectiveness are provided by both single RCTs and case series. The discussed data from clinical studies and observations support the usefulness of topical treatments in neuropathic pain management. This review may help clinicians in making decisions regarding whether and which topical treatment may be a beneficial option, particularly in frail patients not tolerating systemic pharmacotherapy.

scholarly journals Saffron (Crocus sativus L.) in Ocular Diseases: A Narrative Review of the Existing Evidence from Clinical Studies

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 649 ◽  
Author(s):  
Rebekka Heitmar ◽  
James Brown ◽  
Ioannis Kyrou
Keyword(s):  
Clinical Studies ◽  
Wide Spectrum ◽  
Narrative Review ◽  
Age Related Macular Degeneration ◽  
Crocus Sativus ◽  
Ocular Diseases ◽  
Neuroprotective Effects ◽  
Age Related ◽  
Underlying Mechanisms ◽  
Crocus Sativus L

Saffron (Crocus sativus L.) and its main constituents, i.e., crocin and crocetin, are natural carotenoid compounds, which have been reported to possess a wide spectrum of properties and induce pleiotropic anti-inflammatory, anti-oxidative, and neuroprotective effects. An increasing number of experimental, animal, and human studies have investigated the effects and mechanistic pathways of these compounds in order to assess their potential therapeutic use in ocular diseases (e.g., in age related macular degeneration, glaucoma, and diabetic maculopathy). This narrative review presents the key findings of published clinical studies that examined the effects of saffron and/or its constituents in the context of ocular disease, as well as an overview of the proposed underlying mechanisms mediating these effects.

scholarly journals Role of Probiotics in Stimulating the Immune System in Viral Respiratory Tract Infections: A Narrative Review

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3163
Author(s):  
Liisa Lehtoranta ◽  
Sinikka Latvala ◽  
Markus J. Lehtinen
Keyword(s):  
Immune System ◽  
Respiratory Tract ◽  
Clinical Studies ◽  
Viral Infections ◽  
Narrative Review ◽  
Virus Infections ◽  
Respiratory Illnesses ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Viral Respiratory

Viral respiratory tract infection (RTI) is the most frequent cause of infectious illnesses including the common cold. Pharmacological solutions for treating or preventing viral RTIs are so far limited and thus several self-care products are available in the market. Some dietary supplements such as probiotics have been shown to modulate immune system function and their role in reducing the risk and the course of RTIs has been investigated extensively within the past decade. However, the mechanism of action and the efficacy of probiotics against viral RTIs remains unclear. We searched PubMed, Google Scholar, and Web of Knowledge for pre-clinical and clinical studies investigating the effect of probiotics on respiratory virus infections, immune response, and the course of upper and lower respiratory tract illness. The literature summarized in this narrative review points out that specific probiotic strains seem effective in pre-clinical models, through stimulating the immune system and inhibiting viral replication. Clinical studies indicate variable efficacy on upper respiratory illnesses and lack proof of diagnosed viral infections. However, meta-analyses of clinical studies indicate that probiotics could be beneficial in upper respiratory illnesses without specific etiology. Further studies aiming at discovering the mechanisms of action of probiotics and clinical efficacy are warranted.

scholarly journals COVID-19 Pandemic - A Narrative Review of the Potential Roles of Chloroquine and Hydroxychloroquine

2020 ◽  
Vol 4S;23 (8;4S) ◽  
pp. S351-S366
Author(s):  
Vanessa B. Boralli
Keyword(s):  
Adverse Effects ◽  
Cardiac Arrhythmias ◽  
Clinical Studies ◽  
Narrative Review ◽  
Efficacy And Safety ◽  
Length Of Treatment ◽  
Lack Of Information ◽  
Small Patient ◽  
High Doses

Background: Chloroquine (CQ) and hydroxychloroquine (HCQ) are old drugs used against malaria, rheumatism, inflammation in the joints, lupus, among others. These drugs showed positive results in preliminary scientific research for treatment of the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Since the studies with CQ and HCQ are initial with small patient populations, it is not yet known whether there are adverse effects from the use of CQ and HCQ for patients infected with the coronavirus. Objectives: The aim of this study was to evaluate the evidence regarding the efficacy and safety of CQ and HCQ used against viral infection caused by SARS-CoV-2. Study Design: This is a narrative review of the traditional prescriptions of CQ and HCQ efficacy and adverse effects as well as their employment for coronavirus disease 2019 (COVID-19). Setting: In vitro and clinical studies comparing the antiviral efficacy and adverse effect profile of CQ and HCQ against COVID-19 in adult patients were evaluated. Methods: A systemic search of reviews, including in vitro and clinical trial studies in English focusing on CQ and HCQ effects and adverse effects against COVID-19 in the adult patient population from PubMed was performed. It included studies reporting chloroquine and hydroxychloroquine effects and adverse effects against COVID-19. Results: A total of 42 articles published between 2004 and April 2020 were reviewed for therapeutic use of CQ and HCQ. Both these drugs showed a significant in vitro potential against coronavirus. Many studies for clinical use of CQ and HCQ showed that patients presented adverse reactions on high doses. Limitations: Clinical studies have some methodology shortcomings, such as lack of information about the treatment and small number of experimental patients, leading to a misinterpretation of the data. Besides, there are few clinical studies with a limited sample size. Moreover, most of them did not present control groups, and some patients had died during these protocols. Discussion: Despite both CQ and HCQ in vitro antiviral evidence, clinically, both drugs, either alone or combined with other medications, may increase the risk of cardiac arrhythmias, leading to cardiac arrest and sudden death. Besides, a lot of uncertainty still remains, such as starting administration period, dose prescribed, length of treatment, patients’ condition, concomitant drug use, among others. Conclusion: From the studies reviewed, it is not possible to state the precise efficacy and safety of CQ and HCQ use in the treatment of COVID-19 at any time in the course of the disease. Future studies are warranted. Key words: SARS-CoV-2; COVID-19; chloroquine; hydroxychloroquine; pandemic; coronavirus; adverse effects; side effects; cardiac arrhythmias; ocular toxicity, retinopathy; pharmacokinetic.

scholarly journals Bezlotoxumab for Preventing Recurrent Clostridioides difficile Infection: A Narrative Review from Pathophysiology to Clinical Studies

2020 ◽  
Vol 9 (3) ◽  
pp. 481-494 ◽  
Author(s):  
Daniele Roberto Giacobbe ◽  
Silvia Dettori ◽  
Stefano Di Bella ◽  
Antonio Vena ◽  
Guido Granata ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Narrative Review ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

scholarly journals Reverse tapered versus non-tapered peripherally inserted central catheters: A narrative review

2021 ◽  
pp. 112972982110099
Author(s):  
Sergio Bertoglio
Keyword(s):  
Clinical Practice ◽  
Clinical Studies ◽  
Postoperative Bleeding ◽  
Narrative Review ◽  
Efficacy And Safety ◽  
Exit Site ◽  
Peripherally Inserted Central Catheters ◽  
Safety And Efficacy ◽  
Central Catheters

Introduced over 20 years ago, the reverse tapering design for PICC catheters is supposed to have some benefits in terms of both efficacy and safety. In particular, it would ensure less postoperative bleeding at the exit site and greater effectiveness in preventing kinking or twisting of the same. Since its introduction, these hypothesized advantages have never been demonstrated in clinical studies, however very scarce, which have highlighted neither advantages nor disadvantages of reverse tapered catheters when compared to non-reverse tapered ones. This narrative review analyzes some aspects of the use of reverse tapered PICCs, also paying attention to some possible undesirable effects that have arisen from the introduction into clinical practice of new subcutaneous systems of securement of PICCs to the skin. Clinicians should be aware of the fact that reverse tapering design does not represents a sure improvement in terms of safety and efficacy of PICCs and its adoption should be weighed against possible clinical disadvantages.

Gastrointestinal abnormalities and Nigella sativa: A narrative review of preclinical and clinical studies

2022 ◽  
pp. 355-386
Author(s):  
Foziyah Zakir ◽  
Harshita Mishra ◽  
Mohammad Azharuddin ◽  
M. Aamir Mirza ◽  
Geeta Aggarwal ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Nigella Sativa ◽  
Narrative Review ◽  
Preclinical And Clinical Studies ◽  
Gastrointestinal Abnormalities

scholarly journals Effect of Age, Sex and Gender on Pain Sensitivity: A Narrative Review

2017 ◽  
Vol 10 (1) ◽  
pp. 44-55 ◽  
Author(s):  
Hanan G. Eltumi ◽  
Osama A. Tashani
Keyword(s):  
Sex Differences ◽  
Clinical Studies ◽  
Pain Sensitivity ◽  
Human Life ◽  
Experimental Studies ◽  
Narrative Review ◽  
Sex And Gender ◽  
Old Patients ◽  
And Gender ◽  
Age And Sex

Introduction: An increasing body of literature on sex and gender differences in pain sensitivity has been accumulated in recent years. There is also evidence from epidemiological research that painful conditions are more prevalent in older people. The aim of this narrative review is to critically appraise the relevant literature investigating the presence of age and sex differences in clinical and experimental pain conditions. Methods: A scoping search of the literature identifying relevant peer reviewed articles was conducted on May 2016. Information and evidence from the key articles were narratively described and data was quantitatively synthesised to identify gaps of knowledge in the research literature concerning age and sex differences in pain responses. Results: This critical appraisal of the literature suggests that the results of the experimental and clinical studies regarding age and sex differences in pain contain some contradictions as far as age differences in pain are concerned. While data from the clinical studies are more consistent and seem to point towards the fact that chronic pain prevalence increases in the elderly findings from the experimental studies on the other hand were inconsistent, with pain threshold increasing with age in some studies and decreasing with age in others. Conclusion: There is a need for further research using the latest advanced quantitative sensory testing protocols to measure the function of small nerve fibres that are involved in nociception and pain sensitivity across the human life span. Implications: Findings from these studies should feed into and inform evidence emerging from other types of studies (e.g. brain imaging technique and psychometrics) suggesting that pain in the older humans may have unique characteristics that affect how old patients respond to intervention.

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