Understanding the HPA response to critical illness: novel insights with clinical implications

Background. The 3A subfamily of cytochrome P450 (CYP3A) accomplishes phase I metabolism for approximately half of the available medications. We aimed to review the recent advances in our understanding of CYP3A activity, which could apply to infants and toddlers.Material and Methods. A literature review.Results. The reviewed recent data cover: CYP3A7 expression and functions, changes of CYP3A4 function in the first two years of life, CYP3A intestinal metabolism and zonation, CYP3A metabolic programming, pediatric CYP3A pharmacogenetics, the impact of critical illness on CYP3A, phenotyping, and other clinical implications of a better comprehension of CYP3A biology.Conclusions. Although the knowledge of CYP3A enzymes has already changed pediatric practice, much more is to be expected in the upcoming years. The areas to watch include: endogenous markers for phenotyping, new CYP3A7 substrates and products, pharmacogenetic interactions with transporter genes for non‑immunomodulatory drugs, as well as interactions with microbiota and specific bioactive foodstuffs.

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Changes in the process of alternative RNA splicing results in soluble B and T lymphocyte attenuator with biological and clinical implications in critical illness

Molecular Medicine ◽

10.1186/s10020-018-0036-3 ◽

2018 ◽

Vol 24 (1) ◽

Cited By ~ 5

Author(s):

Sean F. Monaghan ◽

Debasree Banerjee ◽

Chun-Shiang Chung ◽

Joanne Lomas-Neira ◽

Kamil J. Cygan ◽

...

Keyword(s):

Critical Illness ◽

T Lymphocyte ◽

Rna Splicing ◽

Clinical Implications

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Effects of Selected Rhinologic Disorders on the Perception of Nasal Resonance in Children

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1501.44 ◽

1984 ◽

Vol 15 (1) ◽

pp. 44-50 ◽

Cited By ~ 2

Author(s):

Michael P. Rastatter ◽

Melvin Hyman

Keyword(s):

Allergic Rhinitis ◽

Clinical Implications ◽

Normal Children ◽

Nasal Resonance

A group of sophisticated listeners judged the nasal resonance characteristics of normal children versus children evidencing selected rhinologic disorders under three speaking conditions. Results showed that perceptions of denasality are influenced by both speakers and speaking tasks. That is, children with allergic rhinitis and edemic adenoids were perceived as being denasal when they produced VCV utterances and recited sentences. However, their resonance characteristics were deemed normal for vowel productions. Interestingly, children with severely deviated septums were judged to have normal nasal resonance under all speaking conditions. Clinical implications are discussed.

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Perceptions of Stuttering of Different Age Groups

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig4-2018-0007 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1311-1315

Author(s):

Sergey M. Kondrashov ◽

John A. Tetnowski

Keyword(s):

Age Groups ◽

School Age Children ◽

Clinical Implications ◽

School Age ◽

Fourth Edition ◽

Self Perception ◽

Behavioral Measures ◽

Self Rating ◽

Comparison Results ◽

Subject Pool

Purpose The purpose of this study was to assess the perceptions of stuttering of school-age children who stutter and those of adults who stutter through the use of the same tools that could be commonly used by clinicians. Method Twenty-three participants across various ages and stuttering severity were administered both the Stuttering Severity Instrument–Fourth Edition (SSI-4; Riley, 2009 ) and the Wright & Ayre Stuttering Self-Rating Profile ( Wright & Ayre, 2000 ). Comparisons were made between severity of behavioral measures of stuttering made by the SSI-4 and by age (child/adult). Results Significant differences were obtained for the age comparison but not for the severity comparison. Results are explained in terms of the correlation between severity equivalents of the SSI-4 and the Wright & Ayre Stuttering Self-Rating Profile scores, with clinical implications justifying multi-aspect assessment. Conclusions Clinical implications indicate that self-perception and impact of stuttering must not be assumed and should be evaluated for individual participants. Research implications include further study with a larger subject pool and various levels of stuttering severity.

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Treatment Considerations for Adolescents Who Exhibit Cognitive/Communication Problems: A Neuroscience Perspective

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00071 ◽

2020 ◽

Vol 5 (6) ◽

pp. 1767-1775

Author(s):

Martha S. Burns

Keyword(s):

Social Communication ◽

Transition Period ◽

Clinical Intervention ◽

Review Article ◽

Sensitive Period ◽

Clinical Implications ◽

Evidence Based ◽

Communication Problems ◽

Treatment Considerations ◽

Behavioral Growth

Purpose Adolescence is a period of substantial neurophysiological and behavioral growth, representing a second sensitive period of brain development. It is a psychological and social transition period between childhood and adulthood with many beneficial changes occurring, especially with respect to potential responsiveness to clinical intervention. However, adolescent behavioral complexities introduce clinical challenges as well. The purpose of this review article is to review the current neuroimaging research on neurophysiological changes observed during adolescence and the cognitive and social behavioral counterparts, with specific attention to the clinical implications. The review article will then summarize currently available intervention tools that can be utilized by speech-language pathologists working with this population. It will conclude with available evidence-based social-communication approaches that may be applicable as well as available evidence-based supplemental technological cognitive interventions that may be useful in working with adolescents who exhibit language and communication issues. Conclusion As a transition period between childhood and adulthood, adolescence represents a second sensitive period during which there is opportunity for clinically derived beneficial cognitive and communication growth.

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Laryngeal Manifestations of Autoimmune Diseases

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00168 ◽

2020 ◽

Vol 5 (2) ◽

pp. 439-456

Author(s):

Jenny L. Pierce

Keyword(s):

Autoimmune Disease ◽

Autoimmune Diseases ◽

Patient Outcomes ◽

Correct Diagnosis ◽

Upper Airway ◽

Clinical Implications ◽

Laryngeal Function ◽

The Past ◽

Referral Practices ◽

Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

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