scholarly journals Prognostic Indicators and Treatment Strategies for Diffuse Midline Glioma: a Systematic Review

2021 ◽  
Author(s):  
Michael Fiorino ◽  
Nathan Kostick ◽  
Caroline Baughn ◽  
Alexander Bolufer ◽  
Takuma Iwai ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Treatment Plan ◽  
Treatment Strategies ◽  
Prognostic Indicators ◽  
Search Term ◽  
Medical Subject Headings ◽  
Therapeutic Modalities ◽  
Dismal Prognosis ◽  
Diffuse Midline Glioma

Abstract IntroductionDiffuse Midline Gliomas (DMGs) are a class of grade IV gliomas associated with a very dismal prognosis. Despite many decades of research, a cure for DMG has yet to be found. In this paper, we will review the drugs and therapeutic techniques published in the scientific literature for DMG.MethodsA comprehensive search of current literature was conducted in MEDLINE/PubMed. Relevant studies were identified among those in the English language published after 1990 to the present. The Medical Subject Headings (MeSH) search term consisted of the singular phrase “diffuse midline glioma”. Prior to completion of the full-text review, a total of 298 articles were identified as of 26 April 2021. For this systematic review, 20 studies were included after review.ResultsRecent genetic testing has identified a H3K27M mutation that is characteristic of DMGs. This finding has helped pave the way in developing new therapeutic agents and techniques for DMG. Although these newer drugs and therapeutic modalities have not been shown to cure DMG, some of them have been shown to increase overall survival and reduce symptom severity in select patients.ConclusionsAt this point in time, there is no best treatment agent/modality for patients with DMG; rather, the treatment plan should be tailored to the patient’s specific type of DMG. More research is needed to develop better therapeutics and provide improved outcomes to patients.

scholarly journals Meningoencephalitis associated with COVID-19: A systematic review

2020 ◽  
Author(s):  
Ritwick Mondal ◽  
Upasana Ganguly ◽  
Shramana Deb ◽  
Gourav Shome ◽  
Subhasish Pramanik ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Final Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Neurological Involvement ◽  
P Value ◽  
Neurological Manifestations ◽  
Medical Subject Headings ◽  
Laboratory Findings

AbstractBackground and aimsWith the growing number of COVID-19 cases in recent times, the varied range of presentations is progressively becoming an addressing issue among clinicians. A significant set of patients with extra pulmonary symptoms has been reported worldwide. Neurological involvement in the form of altered mental status, loss of consciousness in considerable amounts has drawn attention of physicians all across the globe. Here we venture out to summarise the clinical profile, investigations and radiological findings among patients with SARS-CoV-2 associated meningoencephalitis in the form of a systematic review, which may aid clinicians in early diagnosis and prognostic evaluation of the disease.MethodologyThis review was carried out based on the existing PRISMA (Preferred Report for Systemic Review and Meta analyses) consensus statement. The data for this review was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase and Cochrane library and Preprint servers up till 10th June, 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes “SARS-COV-2”, “COVID-19”, “meningoencephalitis” etc. All peer reviewed, case control, case report, pre print articles satisfying our inclusion criteria were involved in the study. The inclusion prerequisites comprised of confirmed SARS-CoV-2 cases with neurological manifestations, previous cases of SARS-CoV, MERS-CoV with neurological involvement provided all the studies were published in English language. Quantitative data was expressed in mean+/-SD, while the qualitative date in percentages. Paired t test was used for analysing the data based on differences between mean and respective values with a p value of <0.05 considered to be statistically significant.ResultsA total of 43 cases were involved from 24 studies after screening from databases and preprint servers, out of which 29 of them had completed investigation profile and were included in the final analysis. Clincial and Laboratory findings as well as neuroimaging findings (CT, MRI and MRS) revealed consistent presentations towards association of COVID-19 with meningoencephalitis. Epileptogenic pictures were also evident on EEG (electroencephalogram) findings.ConclusionSARS-CoV-2 has been isolated from CSF as well as cerebrum of cases with meningoencephalitis depicting the natural tendency of the virus to invade the central nervous system. Speculations about retrograde olfactory transport or alternative haematogenous spread seem to be correlating with above findings. This review may raise the index of suspicion about COVID-19 among clinicians while attending patients with neurological manifestations.

scholarly journals Epidemiology of Cardiovascular Diseases in Morocco: A Systematic Review

2021 ◽  
Vol 17 (2) ◽  
pp. 57-67
Author(s):  
Rida Elyamani ◽  
Abdelmajid Soulaymani ◽  
Hind Hami
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Diseases ◽  
English Language ◽  
Local Population ◽  
Treatment Strategies ◽  
Epidemiological Studies ◽  
High Rate ◽  
Systematic Analysis ◽  
Moroccan Population

OBJECTIVE: To provide a systematic review of studies on cardiovascular diseases (CVD) and their risk factors in the Moroccan population. METHODS: A systematic analysis was performed based on PRISMA guidelines by retrieving data bases (Medline, Embase, and other) using technical keywords in addition to manual research on official websites. Published studies in the English or French language, conducted in Morocco or concerning the Moroccan population within the last two decades, were identified. RESULTS: This is the first systematic review of CVD in Morocco. Data from 159 studies were retrieved and analyzed. Most studies were written in the English language (75.89%) and published between 2010 and 2019 (85.47%). The mortality rate caused by CVD in Morocco has reached 38%, with ischemic heart disease and stroke as the main events causing death (31.0% and 22.5% respectively). The risk factors present in the population studied were headed by tobacco smoking (45- 50%), followed by physical inactivity (21.1%), elevated rate of hypertension (25.3%), and depression (5.47%). Impacted by a high rate of illiteracy and poverty and an unprepared health care system in Morocco, these numbers are expected to increase over the next decade. CONCLUSIONS: Based on these alarming incidences, investment in scientific research and epidemiological studies should be increased to determine the needs of the local population. The available evidence shows that the risk of cardiovascular disease and the associated mortality is very high in Morocco and will rise in the next years prospectively, which calls for urgent multi-sectorial approaches and treatment strategies.

scholarly journals Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

2020 ◽  
Vol 9 (1) ◽  
pp. 273 ◽  
Author(s):  
Melissa Frizziero ◽  
Bipasha Chakrabarty ◽  
Bence Nagy ◽  
Angela Lamarca ◽  
Richard A. Hubner ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Molecular Genetic ◽  
Standard Of Care ◽  
Diagnostic Methods ◽  
Neuroendocrine Neoplasms ◽  
Biological Behaviour ◽  
Dismal Prognosis ◽  
Molecular Genetic Data ◽  
Molecular Aberrations

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) represent a rare diagnosis of the gastro-entero-pancreatic tract. Evidence from the current literature regarding their epidemiology, biology, and management is of variable quality and conflicting. Based on available data, the MiNEN has an aggressive biological behaviour, mostly driven by its (often high-grade) neuroendocrine component, and a dismal prognosis. In most cases, the non-neuroendocrine component is of adenocarcinoma histology. Due to limitations in diagnostic methods and poor awareness within the scientific community, the incidence of MiNENs may be underestimated. In the absence of data from clinical trials, MiNENs are commonly treated according to the standard of care for pure neuroendocrine carcinomas or adenocarcinomas from the same sites of origin, based on the assumption of a biological similarity to their pure counterparts. However, little is known about the molecular aberrations of MiNENs, and their pathogenesis remains controversial; molecular/genetic studies conducted so far point towards a common monoclonal origin of the two components. In addition, mutations in tumour-associated genes, including TP53, BRAF, and KRAS, and microsatellite instability have emerged as potential drivers of MiNENs. This systematic review (91 full manuscripts or abstracts in English language) summarises the current reported literature on clinical, pathological, survival, and molecular/genetic data on MiNENs.

scholarly journals The Protective Effects of the Autophagic and Lysosomal Machinery in Vascular and Valvular Calcification: A Systematic Review

2020 ◽  
Vol 21 (23) ◽  
pp. 8933
Author(s):  
Cédric H. G. Neutel ◽  
Jhana O. Hendrickx ◽  
Wim Martinet ◽  
Guido R. Y. De Meyer ◽  
Pieter-Jan Guns
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Treatment Strategies ◽  
Cochrane Library ◽  
Autophagic Flux ◽  
Protective Effects ◽  
Eligibility Criteria ◽  
Lysosomal Function ◽  
Homeostatic Process ◽  
Valvular Calcification

Background: Autophagy is a highly conserved catabolic homeostatic process, crucial for cell survival. It has been shown that autophagy can modulate different cardiovascular pathologies, including vascular calcification (VCN). Objective: To assess how modulation of autophagy, either through induction or inhibition, affects vascular and valvular calcification and to determine the therapeutic applicability of inducing autophagy. Data sources: A systematic review of English language articles using MEDLINE/PubMed, Web of Science (WoS) and the Cochrane library. The search terms included autophagy, autolysosome, mitophagy, endoplasmic reticulum (ER)-phagy, lysosomal, calcification and calcinosis. Study characteristics: Thirty-seven articles were selected based on pre-defined eligibility criteria. Thirty-three studies (89%) studied vascular smooth muscle cell (VSMC) calcification of which 27 (82%) studies investigated autophagy and six (18%) studies lysosomal function in VCN. Four studies (11%) studied aortic valve calcification (AVCN). Thirty-four studies were published in the time period 2015–2020 (92%). Conclusion: There is compelling evidence that both autophagy and lysosomal function are critical regulators of VCN, which opens new perspectives for treatment strategies. However, there are still challenges to overcome, such as the development of more selective pharmacological agents and standardization of methods to measure autophagic flux.

scholarly journals A Systematic Review of Biological Mechanisms of Fatigue in Chronic Illness

2018 ◽  
Vol 20 (4) ◽  
pp. 410-421 ◽  
Author(s):  
Lea Ann Matura ◽  
Susan Malone ◽  
Rosario Jaime-Lara ◽  
Barbara Riegel
Keyword(s):  
Systematic Review ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Hpa Axis ◽  
Chronic Illnesses ◽  
Chronic Obstructive ◽  
Search Term ◽  
Biological Mechanisms ◽  
Medical Subject Headings ◽  
Autonomic Nervous

Fatigue, a commonly reported symptom, is defined as an overwhelming, debilitating, and sustained sense of exhaustion that decreases the ability to function and carry out daily activities. To date, cancer researchers have been in the forefront in investigating the possible biological mechanisms of fatigue, identifying inflammation, dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, and activation of the autonomic nervous system. The purpose of this systematic review is to describe fatigue and what is known about the biological mechanisms described in cancer in five chronic, noninfectious illnesses: heart failure, multiple sclerosis, chronic kidney disease, rheumatoid arthritis, and chronic obstructive pulmonary disease. We searched PubMed and EMBASE using fatigue as a major Medical subject headings (MeSH) heading with each individual disease added as a search term followed by each biological mechanism. We included only primary research articles published in English between 1996 and 2016 describing studies conducted in adult humans. We identified 26 relevant articles. While there is some evidence that the biological mechanisms causing fatigue in cancer are also associated with fatigue in other chronic illnesses, more research is needed to explore inflammation, the HPA axis, and the autonomic nervous system, and other mechanisms in relation to fatigue in a variety of chronic illnesses.

scholarly journals Therapeutics of xeroderma pigmentosum: A PRISMA-compliant systematic review

2021 ◽  
Vol 0 ◽  
pp. 1-14
Author(s):  
Fernando Antônio Gomes de Andrade ◽  
Claudio Eduardo de Oliveira Cavalcanti ◽  
Felipe Contoli Isoldi ◽  
Lydia Masako Ferreira
Keyword(s):  
Systematic Review ◽  
Xeroderma Pigmentosum ◽  
Meta Analysis ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Skin Lesions ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Therapeutic Modalities ◽  
Surgical Treatments

Xeroderma pigmentosum is a rare hereditary autosomal recessive genodermatosis. At present, there are many treatment options for xeroderma pigmentosum, covering medical/procedural, surgical and combined modalities. However, the quality of these interventions has not been assessed. Our study aimed to perform a systematic review of the literature regarding the treatment of xeroderma pigmentosum. Multiple medical databases were accessed with the Medical Subject Headings terms; “xeroderma pigmentosum,” “therapeutics” and “surgical procedures, operative” from January 2000 to April 2019, including articles published in Portuguese, Spanish and English (PROSPERO-CRD42018114858). Two hundred and ninety-eight studies were found in the databases researched, of which, after applying the inclusion criteria, only 33 studies remained. The 33 complete articles were read by three of the authors, having been found: 16 reported medical/procedural and 17 reported surgical treatments. Only one clinical study presented a good level of evidence (EL: 2): a randomized clinical trial using a T4 endonuclease V (T4N5) liposome lotion which reduced the development of skin lesions in patients with xeroderma pigmentosum. Amongst surgical modalities, all studies presented low evidence level (EL: 4). Three illustrative cases are also presented, to emphasize the multiple number of times that surgical modalities may be required in these patients. The therapeutic modalities, both clinical and surgical, for xeroderma pigmentosum presented a low level of scientific evidence which did not allow meta-analysis. More therapeutic studies, both clinical and surgical, with better scientific evidence are needed.

scholarly journals Noninterventional Therapies for the Management of Knee Osteoarthritis

2018 ◽  
Vol 32 (01) ◽  
pp. 046-054 ◽  
Author(s):  
Joseph Dadabo ◽  
Julia Fram ◽  
Prakash Jayabalan
Keyword(s):  
Weight Loss ◽  
Knee Osteoarthritis ◽  
Treatment Plan ◽  
Treatment Strategies ◽  
Therapeutic Modalities ◽  
Knee Oa ◽  
Oral Analgesic ◽  
Individualized Approach ◽  
Oral Supplements

AbstractThe goal of the practitioner managing a patient with knee osteoarthritis (OA) is to minimize pain and optimize their function. Several noninterventional (noninjectable) therapies are available for these individuals, each having varying levels of efficacy. An individualized approach to the patient is most beneficial in individuals with knee OA and the treatment plan the practitioner chooses should be based on this principle. The focus of this article is to provide an up-to-date overview of the treatment strategies available, evidence to support them, and in whom these treatments would be most appropriate. These include exercise (aerobic and resistance), weight loss, bracing and orthotics, topical and oral analgesic medications, therapeutic modalities, and oral supplements.

scholarly journals Systematic Review of the Surgical Outcomes of Elbow Plicae

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095516
Author(s):  
In-Ho Jeon ◽  
Hua Liu ◽  
Akriti Nanda ◽  
Hyojune Kim ◽  
Dong Min Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radial Head ◽  
Surgical Outcomes ◽  
English Language ◽  
Cochrane Library ◽  
Medical Subject Headings ◽  
Level Of Evidence ◽  
Residual Symptoms ◽  
Language Studies ◽  
Meta Analyses

Background: Surgical resection is usually required for symptomatic elbow plicae that have failed nonoperative therapy. However, evidence of surgical outcomes has not been presented. Purpose: To review the surgical outcomes for the treatment of synovial plicae in the radiocapitellar joint. Study Design: Systematic review; Level of evidence, 4. Methods: We searched the PubMed, Ovid/MEDLINE, Cochrane Library, Google Scholar, and Embase databases using keywords as well as Medical Subject Headings terms and Emtree ([(elbow OR humeroradial joint OR radiohumeral joint) AND (meniscus OR plica)] OR snapping elbow OR snapping triceps OR synovial fold syndrome OR synovial fringe) for English-language studies. We conducted a systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: A total of 14 articles comprising four level 5 and ten level 4 studies were identified, including 279 patients (284 elbows). The triggering factors reported for 58 patients were heavy labor (29 patients; 50.0%), sporting activities (17 patients; 29.3%), and nonspecific trauma (12 patients; 20.7%). Overall, 92 patients (33.0%) were administered a steroid injection before surgery. Arthroscopic plica resection was performed in 266 patients (95.3%). Intraoperatively, plicae were mostly found in the posterior (44.0%) and posterolateral (28.6%) sites, and chondromalacia of the radial head was observed in 25 patients (9.2%). Of the reported surgical outcomes, 67.7% showed a resolution of symptoms. However, 9.3% of patients had residual symptoms, which were likely associated with pre-existing radial head chondromalacia. The complication rate was reported as 1.8%. Conclusion: Symptomatic elbow plicae were mostly treated arthroscopically, with most of the results being favorable. Pre-existing chondromalacia and the underestimation of concomitant intra-articular abnormalities may yield an inferior outcome.

scholarly journals New approaches to treating resistant depression

2015 ◽  
Vol 21 (5) ◽  
pp. 315-323 ◽  
Author(s):  
Philip J. Cowen ◽  
Ian M. Anderson
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Treatment Plan ◽  
Treatment Strategies ◽  
Therapeutic Modalities ◽  
Recommended Treatment ◽  
Therapeutic Engagement ◽  
Experimental Approaches ◽  
Resistant Depression ◽  
Combine Drug ◽  
Subsequent Relapse

SummaryPersistent major depression that does not respond to adequate first- or second-line treatment is a common problem in psychiatry. This article updates evidence on recommended treatment strategies and reviews the prospects of more experimental approaches. The main pharmacological development in recent years has been the demonstration that several atypical antipsychotic drugs are effective adjunctive agents in improving symptoms in depression unresponsive to selective serotonin reuptake inhibitors, although their adverse effect burden is high. There is optimism about novel pharmacological strategies based on glutamatergic and anti-inflammatory mechanisms. It is important to combine drug and psychological treatments whenever possible. With persistent therapeutic engagement, the majority of patients remit eventually, but subsequent relapse remains a problem. Clinicians should pursue an active and collaborative treatment plan that makes use of all effective therapeutic modalities and continues into the relapse-prevention phase.

scholarly journals Management of Graves’ Hyperthyroidism: More Than a Century of Progression

2020 ◽  
Vol 18 (Suppl) ◽  
Author(s):  
Hengameh Abdi ◽  
Atieh Amouzegar
Keyword(s):  
English Language ◽  
Treatment Strategies ◽  
Primary Treatment ◽  
Therapeutic Modality ◽  
Antithyroid Drugs ◽  
Efficacy And Safety ◽  
Therapeutic Modalities ◽  
Advantages And Disadvantages ◽  
History Of

Context: There are three therapeutic modalities for the management of Graves’ disease (GD), including thyroid surgery, radioactive iodine (RAI), and antithyroid drugs (ATDs). We aimed to briefly review the history of these treatment strategies and their advantages and disadvantages. Evidence Acquisition: We searched PubMed for English language articles using pertinent search terms. Results: Each treatment modality for GD is accompanied by several advantages and disadvantages. Nowadays, ATDs are the most commonly prescribed therapy for GD worldwide. The lack of well-designed, large RCTs comparing three different treatments for hyperthyroidism concerning various short-term and long-term outcomes has led to remarkable uncertainty in the preference of each of these treatments, as is evident in relevant guidelines from different societies. Recently, the efficacy and safety of long-term use of ATDs have been documented. Conclusions: Pros and cons of each therapeutic modality for Graves’ hyperthyroidism should be taken into account during the physician-patient discussion to select the primary treatment. Considering recent data about the long-term efficacy and safety of ATDs, it seems that the appropriate selection of Graves’ patients for long-term ATD therapy can be a new avenue in the treatment and even cure of GD.

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