scholarly journals Chronic Constipation: Current Management and Challenges

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 5B-6B
Author(s):  
Martin Storr
Keyword(s):  
Canadian Journal ◽  
Chronic Constipation ◽  
Initial Treatment ◽  
Unmet Needs ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Current Management ◽  
Novel Drugs ◽  
Canadian Market

Many challenges are associated with the diagnosis and management of patients with chronic constipation. Some of these challenges arise from the currently incomplete understanding of what causes constipation and from the difficulties in diagnosing and classifying the heterogeneous group of patients with chronic constipation. Despite the availability of different treatment options for constipation, an unmet need for drugs in the treatment of patients with chronic constipation remains. This holds especially true for patients who fail an initial treatment. With promising novel drugs either close to approval for the Canadian market or on the horizon, many of these unmet needs may be addressed. The present supplement toThe Canadian Journal of Gastroenterologyprovides an educational overview of the current understanding of the diagnosis, epidemiology, pathophysiology and management of chronic constipation, and summarizes current treatment options in light of current and newly available drugs.

scholarly journals Chronic Constipation: Current Management and Challenges

2011 ◽  
Vol 25 (suppl b) ◽  
pp. 5B-6B ◽  
Author(s):  
Martin Storr
Keyword(s):  
Canadian Journal ◽  
Chronic Constipation ◽  
Initial Treatment ◽  
Unmet Needs ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Current Management ◽  
Novel Drugs ◽  
Canadian Market

Many challenges are associated with the diagnosis and management of patients with chronic constipation. Some of these challenges arise from the currently incomplete understanding of what causes constipation and from the difficulties in diagnosing and classifying the heterogeneous group of patients with chronic constipation. Despite the availability of different treatment options for constipation, an unmet need for drugs in the treatment of patients with chronic constipation remains. This holds especially true for patients who fail an initial treatment. With promising novel drugs either close to approval for the Canadian market or on the horizon, many of these unmet needs may be addressed. The present supplement toThe Canadian Journal of Gastroenterologyprovides an educational overview of the current understanding of the diagnosis, epidemiology, pathophysiology and management of chronic constipation, and summarizes current treatment options in light of current and newly available drugs.

scholarly journals Inflammasomes and Proteostasis Novel Molecular Mechanisms Associated With Atrial Fibrillation

2020 ◽  
Vol 127 (1) ◽  
pp. 73-90 ◽  
Author(s):  
Na Li ◽  
Bianca J.J.M. Brundel
Keyword(s):  
Atrial Fibrillation ◽  
Histone Deacetylases ◽  
Molecular Mechanisms ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Cytoskeletal Proteins ◽  
Age Related ◽  
Research Findings ◽  
Shock Proteins

Atrial fibrillation (AF), the most common progressive and age-related cardiac arrhythmia, affects millions of people worldwide. AF is associated with common risk factors, including hypertension, diabetes mellitus, and obesity, and serious complications such as stroke and heart failure. Notably, AF is progressive in nature, and because current treatment options are mainly symptomatic, they have only a moderate effect on prevention of arrhythmia progression. Hereto, there is an urgent unmet need to develop mechanistic treatments directed at root causes of AF. Recent research findings indicate a key role for inflammasomes and derailed proteostasis as root causes of AF. Here, we elaborate on the molecular mechanisms of these 2 emerging key pathways driving the pathogenesis of AF. First the role of NLRP3 (NACHT, LRR, and PYD domains-containing protein 3) inflammasome on AF pathogenesis and cardiomyocyte remodeling is discussed. Then we highlight pathways of proteostasis derailment, including exhaustion of cardioprotective heat shock proteins, disruption of cytoskeletal proteins via histone deacetylases, and the recently discovered DNA damage-induced nicotinamide adenine dinucleotide + depletion to underlie AF. Moreover, potential interactions between the inflammasomes and proteostasis pathways are discussed and possible therapeutic targets within these pathways indicated.

Treatment outcomes of radiotherapy versus prostatectomy for localized prostate cancer with Gleason 8 or more on biopsy.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 120-120
Author(s):  
Christopher Baker ◽  
Andrew M. McDonald ◽  
Grant Clark ◽  
Caleb Dulaney ◽  
Eddy Shih-Hsin Yang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Initial Treatment ◽  
Treatment Options ◽  
Current Treatment ◽  
Biochemical Failure ◽  
Localized Prostate Cancer ◽  
Kaplan Meier ◽  
Initial Biopsy

120 Background: There have been no prospective randomized controlled trials comparing current treatment options for patients with high-risk localized prostate cancer. This study seeks to compare the biochemical and metastatic outcomes of patients that received definitive radiotherapy (dRT) or radical prostatectomy (RP) for localized prostate cancer with Gleason score ≥ 8 on initial biopsy. Methods: A total of 106 patients met the inclusion criteria of Gleason score ≥ 8 on initial biopsy and biochemical follow-up ≥ 1 year. Seventy-one patients were initially treated with dRT (96% also receiving androgen deprivation therapy) and 35 patients were initially treated with RP (with or without postoperative RT). Our primary endpoint was biochemical failure (BF). For dRT patients, BF was recorded according to the Phoenix Consensus or if extranodal metastasis was diagnosed. For surgical patients, BF was recorded according to American Urological Association guidelines or if extranodal metastasis occurred. If adjuvant/salvage RT was given postoperatively, BF was recorded if PSA ≥ 0.5 on two consecutive measures after completion of RT. Pretreatment characteristics were compared using Pearson Chi-square method and independent samples Mann-Whitney U test. Actuarial rates of BF and metastasis were calculated using the Kaplan-Meier method. Results: Median follow-up for all patients was 5.3 years. There was no statistical difference in clinical T-stage, initial PSA, or months of follow up between patients treated initially with radiotherapy vs. prostatectomy. Patients initially treated with dRT were significantly older than those treated with RP. The dRT group had a lower rate of BF compared to the RP group, p < 0.001. The Kaplan-Meier estimate of BF at 5 years was 7.6% in the dRT group compared to 34.5% in the RP group. Additionally, the Kaplan-Meier estimate of distant metastasis at 10 years was 22.7% in the dRT group compared to 55.9% of the RP group, p = 0.01. Conclusions: For our sample of patients with Gleason score ≥ 8 on initial biopsy, initial treatment with dRT was associated with lower rates of biochemical failure and extranodal metastasis when compared to initial treatment with prostatectomy.

scholarly journals Atypical localization of Eph-RTKs in childhood cancer rhabdomyosarcoma

2019 ◽  
Author(s):  
◽  
Ronnie Marie LaCombe
Keyword(s):  
Cancer Progression ◽  
Tyrosine Kinases ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Eph Receptors ◽  
Primary Tumors ◽  
Eph Receptor ◽  
First Case ◽  
Tumor Types

Rhabdomyosarcoma (RMS), the most common soft tissue tumor in children, is an aggressive cancer with a 5-year survival rate of 24% if it has metastasized. Current treatment options are limited to surgery, chemotherapy and radiation, so there is a significant unmet need for targeted therapies. Eph receptor tyrosine kinases have been implicated in the development and progression of many other tumor types. Recent results from our group identified several Eph receptors expressed by primary muscle stem cells (satellite cells), which led us to screen for protein expression of Ephs in canine RMS primary tumors as well as mouse and human RMS cell lines. Intriguingly, we noted strong expression but abnormal localization of one Eph receptor: in multiple tumors from all three species, we detected EphA1 in the nucleus of interphase cells. Mislocalization of RTKs to the nucleus in other tumor types has been shown to promote cancer progression, with the classic case being ErbBs. There are only two published studies about Ephs localizing to the nucleus and to date no other nuclear RTKs have been identified in RMS. These data represent the first case of a nuclear RTK in RMS, and the first time that EphA1 has been detected in the nucleus of any cell type.

scholarly journals Autoimmune thrombocytopenia: Current treatment options in adults with a focus on novel drugs

2019 ◽  
Vol 103 (6) ◽  
pp. 531-541 ◽  
Author(s):  
Michał Witkowski ◽  
Magdalena Witkowska ◽  
Tadeusz Robak
Keyword(s):  
Treatment Options ◽  
Current Treatment ◽  
Autoimmune Thrombocytopenia ◽  
Novel Drugs

scholarly journals Choosing the right treatment for patients with psoriatic arthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2096262
Author(s):  
Maria Noviani ◽  
Marie Feletar ◽  
Peter Nash ◽  
Ying Ying Leung
Keyword(s):  
Psoriatic Arthritis ◽  
Treatment Options ◽  
Unmet Need ◽  
Current Treatment ◽  
Low Disease Activity ◽  
Appropriate Treatment ◽  
Chronic Inflammatory Condition ◽  
Axial Disease ◽  
Inflammatory Bowel ◽  
The Right

Psoriatic arthritis (PsA) is a chronic inflammatory condition with articular and extra-articular manifestations: peripheral arthritis, axial disease, enthesitis, dactylitis, psoriasis, inflammatory bowel disease and uveitis. Anti-tumour necrosis factors (anti-TNFs) have demonstrated clinical efficacies exceeding those of conventional disease-modifying antirheumatic drugs (DMARDs). New understanding in pathogenic pathways have led to novel therapeutic targets. The current treatment paradigms emphasize early diagnosis and treatment, and treating towards remission and low disease activity status, particularly in long-standing disease. This review addresses the evidence of current treatment options for each of the domains of PsA. We present a simple guide that weighs on clinical efficacies for each PsA domain to aid clinicians in choosing the most appropriate treatment for patients. We highlight the unmet need for biomarkers of treatment response, and future perspectives with precision medicine in PsA.

scholarly journals Treating Allergic Conjunctivitis: A Once-daily Medication that Provides 24-hour Symptom Relief

2016 ◽  
Vol 7 (2) ◽  
pp. ar.2016.7.0158 ◽  
Author(s):  
Warner Carr ◽  
Jack Schaeffer ◽  
Eric Donnenfeld
Keyword(s):  
Mast Cell ◽  
Allergic Conjunctivitis ◽  
Treatment Options ◽  
Symptom Relief ◽  
Unmet Need ◽  
Signs And Symptoms ◽  
Current Treatment ◽  
Duration Of Action ◽  
Once Daily ◽  
Stabilizing Agents

Background Allergic conjunctivitis (AC) is a common ocular inflammatory manifestation of allergen exposure in sensitized individuals. Signs and symptoms of AC can decrease quality of life, interfere with productivity, and lead to considerable economic burden. Consistent suppression of conjunctival inflammation is necessary for managing AC, but currently available medications require frequent administration and exhibit limited duration of action. Methods In this review, we summarized AC pathogenesis, diagnosis, and current treatment options as well as their limitations. Findings from the literature were discussed in the context of the unmet need for a once-daily medication with sustained 24-hour effectiveness. Results Topical pharmacologic treatments are the most common approach for managing extant AC; however, most available medications require multiple daily instillations. Dual-acting antihistamine-mast cell stabilizing agents are currently considered first-line therapeutics for AC because they provide acute relief of signs and symptoms and block persistent inflammation to promote regression of AC. Recent studies of a newly-developed, higher-concentration formulation of a dual-acting antihistamine-mast cell stabilizer have demonstrated that this formulation provides a 24-hour duration of action with once-daily dosing. Conclusions Dual-acting AC medications exhibit a high degree of overall effectiveness and are well tolerated for chronic use. A newly available once-daily medication that manages signs and symptoms of AC for a full 24 hours may be considered a treatment of choice for patients experiencing seasonal or perennial AC. ClinicalTrials.gov NCT01743027 and NCT01479374

scholarly journals Chronic constipation: diagnosis and current treatment options

Prescriber ◽  
2010 ◽  
Vol 21 (9) ◽  
pp. 30-45 ◽  
Author(s):  
Paul Blaker ◽  
Mark Wilkinson
Keyword(s):  
Chronic Constipation ◽  
Treatment Options ◽  
Current Treatment

An Overview of Dementias

2012 ◽  
Vol 21 (3) ◽  
pp. 75-84
Author(s):  
Venkata Vijaya K. Dalai ◽  
Jason E. Childress ◽  
Paul E Schulz
Keyword(s):  
Clinical Presentation ◽  
Treatment Options ◽  
Current Treatment ◽  
Great Variability ◽  
Health Concern ◽  
Public Health Concern ◽  
Life Threatening ◽  
The Common ◽  
Neurodegenerative Dementias ◽  
Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

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