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1.
The Effect of Inflammation on Bone.
Epsley, S, Tadros, S, Farid, A, Kargilis, D, Mehta, S, Rajapakse, CS
Frontiers in physiology. 2020;:511799
Abstract
Bone remodeling is the continual process to renew the adult skeleton through the sequential action of osteoblasts and osteoclasts. Nuclear factor RANK, an osteoclast receptor, and its ligand RANKL, expressed on the surface of osteoblasts, result in coordinated control of bone remodeling. Inflammation, a feature of illness and injury, plays a distinct role in skewing this process toward resorption. It does so via the interaction of inflammatory mediators and their related peptides with osteoblasts and osteoclasts, as well as other immune cells, to alter the expression of RANK and RANKL. Such chemical mediators include TNFα, glucocorticoids, histamine, bradykinin, PGE2, systemic RANKL from immune cells, and interleukins 1 and 6. Conditions, such as periodontal disease and alveolar bone erosion, aseptic prosthetic loosening, rheumatoid arthritis, and some sports related injuries are characterized by the result of this process. A thorough understanding of bone response to injury and disease, and ability to detect such biomarkers, as well as imaging to identify early structural and mechanical property changes in bone architecture, is important in improving management and outcomes of bone related pathology. While gut health and vitamin and mineral availability appear vitally important, nutraceuticals also have an impact on bone health. To date most pharmaceutical intervention targets inflammatory cytokines, although strategies to favorably alter inflammation induced bone pathology are currently limited. Further research is required in this field to advance early detection and treatments.
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Prevention of adolescent obesity: The global picture and an indian perspective.
Srivastav, P, Broadbent, S, K, V, Nayak, B, Bhat, HV
Diabetes & metabolic syndrome. 2020;(5):1195-1204
Abstract
BACKGROUND AND AIMS Adolescent obesity is an increasing health burden with a growing prevalence in low- and middle-income countries. The aim of this review is to assess and compare current best practice obesity prevention interventions for adolescents in developed nations and in India METHODS Medline (PubMed), CINAHL, Scopus and Google Scholar electronic databases from 2000 to 2020 were searched using the key terms obesity, overweight, child and adolescent obesity, child and adolescent overweight, interventions for childhood and adolescent obesity and dietary interventions for adolescents, developed countries, and India. RESULTS Developed nations worldwide have formed and implemented policies and programs at national and local levels to attempt to minimize and manage adolescent obesity. In 2019, scientific and government consultation groups in India have recommended national cross-sectoral structures to action interventions to restrict high-fat food intake, increase physical activity in children and adolescents and to link current research and school-based interventions in a national framework. CONCLUSIONS Obesity is a multifactorial problem, and multimodal interventions involving all Indian stakeholders, combined with government policy reform, are urgently needed.
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3.
Heavy Menstrual Bleeding in Adolescent Girls.
Davila, J, Alderman, EM
Pediatric annals. 2020;(4):e163-e169
Abstract
Heavy menstrual bleeding (HMB) is a common complaint among adolescent girls. It reflects an abnormal volume of blood loss during the menstrual cycle. Abnormal uterine bleeding can manifest as HMB but includes menstrual irregularity. In many cases, immaturity of the hypothalamic-pituitary-ovarian axis or hormonal conditions like polycystic ovarian syndrome leading to anovulatory cycles are the underlying cause for heavy menses. However, in girls with HMB, especially those not responding to the usual hormonal attempts to manage HMB, an underlying bleeding disorder should be considered. Up to 62% of adolescents with HMB have a bleeding disorder, many without anemia at presentation. Evaluation for HMB in an adolescent girl should include referrals to an adolescent medicine specialist or gynecologist and pediatric hematologist. [Pediatr Ann. 2020;49(4):e163-e169.].
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4.
Clinical utility of genomic signatures in young breast cancer patients: a systematic review.
Villarreal-Garza, C, Ferrigno, AS, De la Garza-Ramos, C, Barragan-Carrillo, R, Lambertini, M, Azim, HA
NPJ breast cancer. 2020;:46
Abstract
Risk stratification by genomic signatures has been shown to improve prognostication and guide treatment decisions among patients with hormone-sensitive breast cancer. However, their role in young women has not been fully elucidated. In this review, a systematic search was conducted for published articles and abstracts from major congresses that evaluated the use of genomic signatures in young breast cancer patients. A total of 71 studies were analyzed, including 561,188 patients of whom 27,748 (4.9%) were young. Women aged ≤40 years were subjected to genomic testing at a similar rate to older women but had a higher proportion of intermediate- to high-risk tumors when classified by EndoPredict (p = 0.04), MammaPrint (p < 0.01), and Oncotype DX (p < 0.01). In young women with low genomic risk, 6-year distant recurrence-free survival was 94%, while 5-year overall survival was nearly 100%. Nonetheless, young patients classified as low-risk had a higher tendency to receive chemotherapy compared to their older counterparts. In conclusion, genomic tests are useful tools for identifying young patients in whom chemotherapy omission is appropriate.
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5.
The role of caregiver speech in supporting language development in infants and toddlers with autism spectrum disorder.
Swanson, MR
Development and psychopathology. 2020;(4):1230-1239
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Abstract
Parents play an essential role in supporting child development by providing a safe home, proper nutrition, and rich educational opportunities. In this article we focus on the role of caregiver speech in supporting development of young children with autism spectrum disorder (ASD). We review studies from typically developing children and children with autism showing that rich and responsive caregiver speech supports language development. Autism intervention studies that target caregiver speech are reviewed as are recent scientific advances from studies of typical development. The strengths and weakness of different techniques for collecting language data from caregivers and children are reviewed, and natural language samples are recommended as best practice for language research in autism. We conclude that caregivers play a powerful role in shaping their children's development and encourage researchers to adapt parent-mediated intervention studies to acknowledge individual differences in parents by using a personalized medicine approach.
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6.
Bioactive Natural Antivirals: An Updated Review of the Available Plants and Isolated Molecules.
Mohan, S, Elhassan Taha, MM, Makeen, HA, Alhazmi, HA, Al Bratty, M, Sultana, S, Ahsan, W, Najmi, A, Khalid, A
Molecules (Basel, Switzerland). 2020;(21)
Abstract
Viral infections and associated diseases are responsible for a substantial number of mortality and public health problems around the world. Each year, infectious diseases kill 3.5 million people worldwide. The current pandemic caused by COVID-19 has become the greatest health hazard to people in their lifetime. There are many antiviral drugs and vaccines available against viruses, but they have many disadvantages, too. There are numerous side effects for conventional drugs, and active mutation also creates drug resistance against various viruses. This has led scientists to search herbs as a source for the discovery of more efficient new antivirals. According to the World Health Organization (WHO), 65% of the world population is in the practice of using plants and herbs as part of treatment modality. Additionally, plants have an advantage in drug discovery based on their long-term use by humans, and a reduced toxicity and abundance of bioactive compounds can be expected as a result. In this review, we have highlighted the important viruses, their drug targets, and their replication cycle. We provide in-depth and insightful information about the most favorable plant extracts and their derived phytochemicals against viral targets. Our major conclusion is that plant extracts and their isolated pure compounds are essential sources for the current viral infections and useful for future challenges.
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7.
Angiogenesis: Promising Therapeutic Target of Metastatic Colon Cancer.
Malla, RR, Marni, R
Critical reviews in oncogenesis. 2020;(2):161-173
Abstract
Colon cancer (CC) is the third most diagnosed cancers globally and second most lethal malignancy in both men and women due to aggressive metastatic ability. Genetic or somatic mutations causes the transformation of normal epithelium of colon into precancerous stage and eventually to metastatic phenotype in nearly 10 to 15 years. This progression is depending heavily on the tumor induced angiogenesis, which significantly impact the survival of the patients. Angiogenesis is majorly promoted by hypoxia, growth factors, macrophages, and non-coding RNAs as well as distinct signaling pathways in metastatic CCs. Blocking of antiangiogenic pathway using phytochemicals, small molecules, synthetic derivatives alone or along with chemotherapeutics substantially enhanced disease control as well as overall survival of patients with metastatic CC in second line treatment. Further, clinical trials showed benefit of adjuvant chemotherapeutics for treating metastatic CC patients. This chapter attempts to summarize the recent updates of angiogenic promotes of metastatic CC and targeted therapeutics for adjuvant therapy in clinical trials.
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8.
Precision Medicine in Neonates: Future Perspectives for the Lung.
Onland, W, Hutten, J, Miedema, M, Bos, LD, Brinkman, P, Maitland-van der Zee, AH, van Kaam, AH
Frontiers in pediatrics. 2020;:586061
Abstract
Bronchopulmonary dysplasia (BPD) is the most common complication of pre-term birth with long lasting sequelae. Since its first description more than 50 years ago, many large randomized controlled trials have been conducted, aiming to improve evidence-based knowledge on the optimal strategies to prevent and treat BPD. However, most of these intervention studies have been performed on a population level without regard for the variation in clinical and biological diversity (e.g., gestational age, ethnicity, gender, or disease progression) between patients that is driven by the complex interaction of genetic pre-disposition and environmental exposures. Nevertheless, clinicians provide daily care such as lung protective interventions on an individual basis every day despite the fact that research supporting individualized or precision medicine for monitoring or treating pre-term lungs is immature. This narrative review summarizes four potential developments in pulmonary research that might facilitate the process of individualizing lung protective interventions to prevent development of BPD. Electrical impedance tomography and electromyography of the diaphragm are bedside monitoring tools to assess regional changes in lung volume and ventilation and spontaneous breathing effort, respectively. These non-invasive tools allow a more individualized optimization of invasive and non-invasive respiratory support. Investigation of the genomic variation in caffeine metabolism in pre-term infants can be used to optimize and individualize caffeine dosing regimens. Finally, volatile organic compound analysis in exhaled breath might accurately predict BPD at an early stage of the disease, enabling clinicians to initiate preventive strategies for BPD on an individual basis. Before these suggested diagnostic or monitoring tools can be implemented in daily practice and improve individualized patient care, future research should address and overcome their technical difficulties, perform extensive external validation and show their additional value in preventing BPD.
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Is wearing a face mask safe for people with epilepsy?
Asadi-Pooya, AA, Cross, JH
Acta neurologica Scandinavica. 2020;(4):314-316
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Abstract
Since December 2019, the world has been experiencing a catastrophic pandemic of coronavirus disease (COVID-19) caused by SARS-CoV-2. This virus primarily targets the human respiratory system. Available information suggests that people with epilepsy (PWE) are not at higher risk of being infected by the virus, nor of more severe COVID-19 manifestations, as a result of the epilepsy alone. However, COVID-19 is a serious disease that currently has no effective treatment or vaccine. A face mask is probably effective in preventing the spread of a respiratory pathogen, at least to some extent. So, should we recommend wearing a face mask to all during a pandemic of respiratory infectious disease (eg, COVID-19) without any precautions or exemptions? While concrete evidence is lacking, if we consider that wearing a face mask may simulate hyperventilation, at least to some extent, we would probably avoid recommending this practice indiscriminately to all PWE. On the other hand, in the absence of any proven treatment or vaccine to combat COVID-19, prevention is the best available strategy and it is probably not reasonable to suggest avoid wearing face masks in PWE under any circumstances. Logically, PWE do not need to wear a face mask most of the time, as long as there is no close contact with others, especially during intense physical activities such as exercise. To the contrary, it is probably more advantageous to wear a face mask in crowded locations, with intermittent breaks in safe locations, away from others.
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10.
Prevention of cisplatin-induced ototoxicity in children and adolescents with cancer: a clinical practice guideline.
Freyer, DR, Brock, PR, Chang, KW, Dupuis, LL, Epelman, S, Knight, K, Mills, D, Phillips, R, Potter, E, Risby, D, et al
The Lancet. Child & adolescent health. 2020;(2):141-150
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Abstract
Despite ototoxicity being a prevalent consequence of cisplatin chemotherapy, little guidance exists on interventions to prevent this permanent and progressive adverse event. To develop a clinical practice guideline for the prevention of cisplatin-induced ototoxicity in children and adolescents with cancer, we convened an international, multidisciplinary panel of experts and patient advocates to update a systematic review of randomised trials for the prevention of cisplatin-induced ototoxicity. The systematic review identified 27 eligible adult and paediatric trials that evaluated amifostine, sodium diethyldithiocarbamate or disulfiram, systemic sodium thiosulfate, intratympanic therapies, and cisplatin infusion duration. Regarding systemic sodium thiosulfate, the panel made a strong recommendation for administration in non-metastatic hepatoblastoma, a weak recommendation for administration in other non-metastatic cancers, and a weak recommendation against its routine use in metastatic cancers. Amifostine, sodium diethyldithiocarbamate, and intratympanic therapy should not be routinely used. Cisplatin infusion duration should not be altered as a means to reduce ototoxicity. Further research to determine the safety of sodium thiosulfate in patients with metastatic cancer is encouraged.