scholarly journals Role of dietary therapy in managing epilepsy in children

2021 ◽  
Author(s):  
Mohammed Saeed Babonji ◽  
Zahra Abdullah Alkhatir ◽  
Adel Abed Alharbi ◽  
Buthaynah Abdullah Alghasham ◽  
Ola Lateef Abumansour ◽  
...  
Keyword(s):  
Dravet Syndrome ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Dietary Therapy ◽  
Therapeutic Approaches ◽  
Treatment Regimens ◽  
Ketogenic Diets ◽  
Treatment Plans ◽  
Management Approaches

Ketogenic diets have been proposed as effective management approaches that have been validated by many studies in the literature. The efficacy of administering these treatment modalities has been validated by many studies within epilepsy-related syndromes as Rett syndrome, infantile spasms, GLUT-1 deficiency and Dravet syndrome. As a result, it has been noticed that observable favorable outcomes within the first three months from starting the administration of these treatment regimens. In this literature review, we have discussed the dietary therapeutic approaches for managing epilepsy in children. The findings have been combined from different studies in the literature. Many of them are comparative investigations that have indicated the efficacy of these treatment plans in reducing both the frequency of seizures and adequately inhibiting the development of further epilepsy events. Many mechanisms have been proposed for these treatment modalities to inhibit seizures that are adequately discussed in this article. Based on the current evidence, further awareness approaches should be conducted to increase the administration of these products, especially in pharmaco-resistant cases.

Comorbidity of Migraine and Epilepsy in Pediatrics: A Review

2018 ◽  
Vol 33 (12) ◽  
pp. 801-808 ◽  
Author(s):  
Jasna Jancic ◽  
Vesna Djuric ◽  
Boris Hencic ◽  
John N. van den Anker ◽  
Janko Samardzic
Keyword(s):  
Genetic Basis ◽  
Treatment Options ◽  
Dietary Therapy ◽  
Channel Blockers ◽  
Therapeutic Approaches ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
New Therapeutic Approaches ◽  
Neurologic Disorders

Migraine and epilepsy are classified as chronic paroxysmal neurologic disorders sharing many clinical features, as well as possible treatment options. This review highlights the similarities between migraine and epilepsy in pediatrics, focusing on epidemiologic, pathophysiological, genetic, clinical, and pharmacologic aspects. Despite the fact that several syndromes share symptoms of both migraine and epilepsy, further research is needed to clarify the pathophysiological and genetic basis of their comorbidity. Drugs used for prophylactic therapy of migraine and epilepsy have similar pharmacologic properties. The role of epileptic pharmacotherapy in the prophylaxis of migraine is assessed, including the use of conventional antiepileptic drugs, calcium channel blockers, and nonpharmacologic methods such as dietary therapy, supplements, and vagal nerve stimulation. Further randomized, controlled clinical trials assessing pharmacologic and nonpharmacologic methods for the treatment of both disorders are essential, in order to initiate new therapeutic approaches.

Current Controversies in the Stage-Specific Multidisciplinary Management of Pancreatic Cancer

2014 ◽  
pp. e157-e164 ◽  
Author(s):  
Matthew H. G. Katz ◽  
Jerome Landry ◽  
Hedy Lee Kindler
Keyword(s):  
Pancreatic Cancer ◽  
Systemic Chemotherapy ◽  
Metastatic Cancer ◽  
Clinical Staging ◽  
Newly Diagnosed ◽  
Therapeutic Approaches ◽  
Treatment Regimens ◽  
Localized Disease ◽  
New Strategies

Encouraging therapeutic approaches and treatment regimens for patients with both localized and metastatic pancreatic cancer have emerged over the last 5 years. However, these new strategies have brought important challenges and controversy. Clinical staging criteria are constantly evolving. No system has been uniformly adopted, limiting our understanding of the role of both pancreatectomy and neoadjuvant therapies for localized disease. The role of radiation therapy for the treatment of both resectable and unresectable pancreatic cancer remains unclear despite multiple prospective studies. Although two new systemic chemotherapy regimens have essentially transformed the care of many patients with metastatic cancer, criteria to guide their use in the general population have yet to be clearly established. Herein we provide an overview of these important controversies in the context of a broad update on the stage-specific management of patients with newly diagnosed pancreatic cancer.

scholarly journals Current Evidence on the Use of Antifilarial Agents in the Management of bancroftian Filariasis

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Sumadhya Deepika Fernando ◽  
Chaturaka Rodrigo ◽  
Senaka Rajapakse
Keyword(s):  
Current Evidence ◽  
Endosymbiotic Bacterium ◽  
Infection Rates ◽  
Bancroftian Filariasis ◽  
Drug Management ◽  
Treatment Regimens ◽  
Long Term Impact ◽  
Followup Studies

Many trials have explored the efficacy of individual drugs and drug combinations to treat bancroftian filariasis. This narrative review summarizes the current evidence for drug management of bancroftian filariasis. Diethylcarbamazine (DEC) remains the prime antifilarial agent with a well-established microfilaricidal and some macrofilaricidal effects. Ivermectin (IVM) is highly microfilaricidal but minimally macrofilaricidal. The role of albendazole (ALB) in treatment regimens is not well established though the drug has a microfilaricidal effect. The combination of DEC+ALB has a better long-term impact than IVM+ALB. Recent trials have shown that doxycycline therapy againstWolbachia, an endosymbiotic bacterium of the parasite, is capable of reducing microfilaria rates and adult worm activity. Followup studies on mass drug administration (MDA) are yet to show a complete interruption of transmission, though the infection rates are reduced to a very low level.

scholarly journals Role of laser application in endodontic treatment: a review of literature

2021 ◽  
Author(s):  
Abdulkader Abdulelah Abulhamayel ◽  
Khalid Abdulbaqi Alsulami ◽  
Ali Nasser Alshehri ◽  
Abdullah Hussain Alasmari ◽  
Faisal Ramadan Alzahrani ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
The Other ◽  
Current Evidence ◽  
Selective Absorption ◽  
Laser Application ◽  
Review Of Literature ◽  
Therapeutic Approaches ◽  
Pulp Capping ◽  
Surgical Wounds

Many applications have been previously reported that laser is used in the field of endodontics. It is used in pulp diagnosis, shaping and disinfection of the root canal, endodontic surgeries, modifying the dentin structures, pulpotomy and pulp capping. Our present study aims to review some applications of laser used in the field of endodontics. According to the evidence from current studies in the literature, vital pulp therapeutic approaches for pulpotomy can significantly lead to efficacious and bloodless outcomes by using laser for the following processes: Coagulation, vaporization, and sealing of the blood vessels with potentially sterile minute wounds with no complications. Many advantages have been previously reported for using laser within endodontic surgical procedures, such as coagulation, sterilization, selective absorption, precision, lower rates of complications as inflammation and edema, getting clean, well-sealed surgical wounds, enhanced disinfection characteristics, reduced painful sensations, decreased required sutures due to better hemostasis, and reduced bleeding. On the other hand, applying some laser modalities might not be adequately efficacious according to previous studies in the literature. We recommend that further human prospective to conduct investigations for further validation of the current evidence.

scholarly journals 589 Role of Liver Support Systems in The Management of Post Hepatectomy Liver Failure: A Meta-Analysis and Systematic Review of Literature

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Pufal ◽  
A Lawson ◽  
J Hodson ◽  
M Bangash ◽  
J Patel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Failure ◽  
Support Systems ◽  
Meta Analysis ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Liver Support ◽  
Molecular Adsorbent Recirculating System

Abstract Aim Post hepatectomy liver failure (PHLF) is a rare but serious complication following liver resection. PHLF is associated with high mortality of up to 50% in severe cases. With limited treatment options available, there is a need to evaluate the role of systems that support the function of the liver as treatment modalities following PHLF development. Method The aim of this study was to review the literature and summarise the role of liver support systems (LSS) in the management of PHLF. Publications of interest were identified using systematically designed searches. Following screening, data from the relevant publications were extracted, pooled where possible, and analysed. Results Systematic review identified ten studies, which used either Plasma Exchange (PE) or Molecular Adsorbent Recirculating System (MARS) as LSS after PHLF development. The sample sizes of included studies were small, ranging from N = 2 to N = 13. Across all studies, the pooled 90-day mortality rate was 40% (95% CI: 15% - 68%). However, there was substantial heterogeneity (I2=64%), likely since the studies used a variety of definitions for PHLF and had different selection criteria for patient eligibility for LSS treatment. Conclusions Despite potential benefits, the current evidence is insufficient to recommend LSS for the routine management of severe PHLF, with the current literature consisting of only a limited number of studies. There is a definite need for larger, multicentre, prospective studies evaluating the conventional and newer modalities of support systems with a view to improve the outcomes in this group of patients.

scholarly journals The Role of Extracellular Vesicles in the Hallmarks of Cancer and Drug Resistance

Cells ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 1141 ◽  
Author(s):  
Cristina P. R. Xavier ◽  
Hugo R. Caires ◽  
Mélanie A. G. Barbosa ◽  
Rui Bergantim ◽  
José E. Guimarães ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Extracellular Vesicles ◽  
Genetic Material ◽  
Human Tumor ◽  
Current Evidence ◽  
Drug Resistant ◽  
Intercellular Signaling ◽  
Therapeutic Approaches ◽  
Intercellular Exchange

Extracellular vesicles (EVs) mediate intercellular signaling and communication, allowing the intercellular exchange of proteins, lipids, and genetic material. Their recognized role in the maintenance of the physiological balance and homeostasis seems to be severely disturbed throughout the carcinogenesis process. Indeed, the modus operandi of cancer implies the highjack of the EV signaling network to support tumor progression in many (if not all) human tumor malignancies. We have reviewed the current evidence for the role of EVs in affecting cancer hallmark traits by: (i) promoting cell proliferation and escape from apoptosis, (ii) sustaining angiogenesis, (iii) contributing to cancer cell invasion and metastasis, (iv) reprogramming energy metabolism, (v) transferring mutations, and (vi) modulating the tumor microenvironment (TME) by evading immune response and promoting inflammation. Special emphasis was given to the role of EVs in the transfer of drug resistant traits and to the EV cargo responsible for this transfer, both between cancer cells or between the microenvironment and tumor cells. Finally, we reviewed evidence for the increased release of EVs by drug resistant cells. A timely and comprehensive understanding of how tumor EVs facilitate tumor initiation, progression, metastasis and drug resistance is instrumental for the development of innovative EV-based therapeutic approaches for cancer.

scholarly journals The Role of Insulin-Like Growth Factor System in Soft Tissue Sarcomas: From Physiopathology to Targeted Therapeutic Approaches

Sarcoma ◽  
1998 ◽  
Vol 2 (2) ◽  
pp. 69-76 ◽  
Author(s):  
Walter Zumkeller
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Type I ◽  
Therapeutic Approaches ◽  
Treatment Regimens ◽  
Igf Receptors ◽  
Type I Igf Receptor ◽  
Sarcoma Cells ◽  
Promoter Mutations

Purpose/Results.Although surgical, chemo- and radiotherapeutic treatment regimens in patients with soft tissue sarcomas have constantly been refined over the past two decades, the survival rate for these patients is rather low.Discussion.There is a great need to investigate the mechanisms for oncogenesis and to identify the factors involved in malignant transformation in sarcomas. Among these factors, IGFs are thought to play a pivotal role as progression factors in various types of sarcomas. The dysregulation of the IGF-II synthesis, e.g. by loss of imprinting which occurs in most types of sarcomas, is a permissive effect through the suppression of cell death. In addition, cells that overexpress the typeI IGF receptorsare more susceptible to transformation by oncogenes. AsTP53suppresses the activity of IGF-II P3 and P4, as well as the type I IGF receptor promoter, mutations ofTP53in sarcomas may alternatively lead to the activation of these factors. Finally, the phenomenon of non-islet cell tumour hypoglycaemia that occurs in patients with sarcomas, and which is related to the secretion of IGF-II prohormones, is discussed. Future therapeutic strategies may be based upon the application of antibodies or antisense oligonucleotides directed against the type I IGF receptors, with the common goal of inducing apoptosis in sarcoma cells. Ultimately, these and other therapeutic approaches may lead to a better outcome in patients suffering from sarcoma.

scholarly journals Role of PITRM1 in Mitochondrial Dysfunction and Neurodegeneration

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 833
Author(s):  
Dario Brunetti ◽  
Alessia Catania ◽  
Carlo Viscomi ◽  
Michela Deleidi ◽  
Laurence A. Bindoff ◽  
...  
Keyword(s):  
Mitochondrial Dysfunction ◽  
Mitochondrial Fraction ◽  
Current Evidence ◽  
Mitochondrial Targeting ◽  
Therapeutic Approaches ◽  
Atp Production ◽  
Precursor Proteins ◽  
Toxic Peptides ◽  
Mitochondrial Targeting Sequences

Mounting evidence shows a link between mitochondrial dysfunction and neurodegenerative disorders, including Alzheimer Disease. Increased oxidative stress, defective mitodynamics, and impaired oxidative phosphorylation leading to decreased ATP production, can determine synaptic dysfunction, apoptosis, and neurodegeneration. Furthermore, mitochondrial proteostasis and the protease-mediated quality control system, carrying out degradation of potentially toxic peptides and misfolded or damaged proteins inside mitochondria, are emerging as potential pathogenetic mechanisms. The enzyme pitrilysin metallopeptidase 1 (PITRM1) is a key player in these processes; it is responsible for degrading mitochondrial targeting sequences that are cleaved off from the imported precursor proteins and for digesting a mitochondrial fraction of amyloid beta (Aβ). In this review, we present current evidence obtained from patients with PITRM1 mutations, as well as the different cellular and animal models of PITRM1 deficiency, which points toward PITRM1 as a possible driving factor of several neurodegenerative conditions. Finally, we point out the prospect of new diagnostic and therapeutic approaches.

scholarly journals Ligamentization and Remnant Integration: Review and Analysis of Current Evidence and Implications for Scapholunate Reconstruction

2020 ◽  
Author(s):  
Tim A. J. Lindsay ◽  
Harley R. Myers ◽  
Stephen Tham
Keyword(s):  
Systematic Review ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Scapholunate Ligament ◽  
Level Of Evidence ◽  
Interosseous Ligament ◽  
Level I ◽  
Graft Remodelling

Abstract Background Scapholunate interosseous ligament injuries are common but remain a therapeutic challenge. Current treatment modalities prioritize restoration of normal anatomy with reconstruction where appropriate. To date no reconstructive technique has been described that discusses the potential benefit of preservation of the scapholunate ligament remnant. Little is known about the “ligamentization” of grafts within the wrist. However, a growing body of knee literature suggests that remnant sparing may confer some benefit. In the absence of wrist specific studies, this literature must guide areas for potential augmentation of current surgical practices. Objective The purpose of this study was to perform a review of the process of ligamentization and a systematic review of the current literature on the possible role of ligament sparring and its effect on ligamentization. Methods A systematic search of the literature was performed to identify all the studies related to remnant sparing and the ligamentization of reconstructed tendons, regardless of graft type or joint involved from MEDLINE, EMBASE, and PubMed until February 1, 2016 using the following keywords: ligamentization, graft, remodelling, reconstruction, biomechan*, histolo∗, scapholunate ligament. Each selected study was evaluated for methodological quality and risk of bias according to a modified Systematic Review Center for Laboratory Animal Experimentation criteria. Conclusions The available literature suggests that ligament sparring demonstrated a trend toward improvements in vascularity, mechanoreceptors, and biomechanics that lessens in significance over time. Clinical Relevance This review suggests that remnant sparing may be one way to improve outcomes of scapholunate ligament reconstructive surgery. Level of Evidence This is a level I/II, review study.

scholarly journals Tumor-Associated Neutrophils in Hepatocellular Carcinoma Pathogenesis, Prognosis, and Therapy

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2899
Author(s):  
Konstantinos Arvanitakis ◽  
Ioannis Mitroulis ◽  
Georgios Germanidis
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Investigation ◽  
Primary Liver Cancer ◽  
Tumor Therapy ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Anticancer Treatment ◽  
And Migration ◽  
Tumor Associated Neutrophils

Hepatocellular carcinoma represents the most prevalent primary liver cancer worldwide, and it is either caused by intrinsic genetic mutations or by a multitude of extrinsic risk factors. Even though the interplay between chronic inflammatory changes and hepatocarcinogenesis has been at the forefront of clinical investigation for the past few decades, the role of tumor-associated neutrophils (TANs) in HCC development still remains ambiguous. On the one hand, N1 TANs exhibit an anti-tumorigenic activity, mediated by direct or indirect tumor cell lysis, whereas on the other hand, N2 TANs have been correlated with increased HCC growth, invasiveness, and metastasis. The association of an elevated Neutrophil-to-Lymphocyte Ratio (NLR) with poor prognosis in patients with HCC, has been recently brought into spotlight, consolidating its widespread use as a reliable biomarker. Due to the decisive involvement of TANs in HCC pathogenesis and development, the utilization of various neutrophil-centered anticancer treatment modalities has been under clinical experimentation, selectively targeting and modulating the processes of neutrophil recruitment, activation, and migration. This review summarizes current evidence on the role of TANs in HCC pathogenesis and progression, as well as in their potential involvement in tumor therapy, shedding light on emerging anticancer treatment methods targeting neutrophils.

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