scholarly journals Immunological background for treatments with biologicals in CRSwNP

2021 ◽  
Vol 5 (1) ◽  
pp. 022-029
Author(s):  
Klimek L ◽  
Hagemann J ◽  
Casper I ◽  
Huppertz T ◽  
Bedbrook A ◽  
...  

Background: Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammatory disease of the nasal and paranasal mucosa. To date, no internationally standardized uniform classification has been developed for this disease. Usually, a phenotype classification according to CRS with (CRSwNP) and without (CRSsNP) polyposis is performed. However, through a variety of studies, it has been shown that even within these phenotypes, different endotypes of CRS exist, each with a different underlying inflammatory pathophysiology. In this mini-review, we aim to outline the essential immunological processes in CRSwNP and to highlight the modern therapeutic options with biologics derived from this disease. Methods: Current knowledge on the immunological and molecular processes of CRS, especially CRSwNP, was compiled by means of a structured literature review. Medline, PubMed, national/international trial and guideline registries as well as the Cochrane Library were all searched. Results: Based on the current literature, the different immunological processes involved in CRS and nasal polyps were elaborated. Current studies on the therapy of eosinophilic diseases such as asthma and polyposis are presented and their results discussed. Conclusion: Understanding the immunological basis of CRSwNP may help to develop new personalized therapeutic approaches using biologics. Currently, 2 biologics (dupilumab, omalizumab) have been approved for the therapy of CRSwNP (polyposis nasi) in Europe.

2020 ◽  
pp. emermed-2019-208970
Author(s):  
James Matthew Brice ◽  
Adrian A Boyle

ObjectivesCommunity violence bears significant human and economic costs. Furthermore, victims requiring ED treatment are at a greater risk of violent reinjury, arrest due to perpetration and violent death. We aimed to evaluate the effectiveness of ED-based violence intervention programmes (EVIPs), which aim to reduce future violence involvement in these individuals.MethodsWe performed a systematic literature review searching MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, The Cochrane Library and Web of Science, in addition to hand-searching. Randomised controlled trials (RCTs) were included if they enrolled victims of community violence requiring ED treatment, evaluated interventions taking place in the ED and used violent revictimisation, arrests or intermediate outcome measures as endpoints. We included trials that had a Jadad score of 2 or above.Results297 records were identified, and 13 articles were included in our final qualitative analysis, representing 10 RCTs and 9 different EVIPs. The risk of selection bias was low; the risk of performance, detection and attrition bias was moderate. 9 out of 13 papers reported statistically significant improvements in one or more outcome measures related to violence, including violent reinjury and arrests due to violence perpetration.ConclusionThe results of this literature review show that EVIPs may be capable of reducing violent reinjury and arrests due to violence perpetration. Larger RCTs, taking place in different regions, in different age groups and using different techniques, are justified to determine which conditions may be required for success and whether EVIPs are generalisable.


2018 ◽  
Vol 23 (2) ◽  
pp. 108-116 ◽  
Author(s):  
Kyrie A. Sweeney ◽  
Kate Cogill ◽  
Katrina Davis ◽  
Jacqueline I. Jauncey-Cooke

Abstract Aim: This review aims to present a case series on pressure injury (PI) formation secondary to limb-splinting for preservation of peripheral intravascular catheter (PIVC) access in neonatal and pediatric patients. A literature review was undertaken to analyze the existing knowledge base on this phenomenon. Background: Medical devices and attachments are considered a risk factor for PI development in neonates, infants, and children. Three cases of PI formation caused by contact with limb boards used to preserve PIVC access were identified in an Australian tertiary pediatric facility during 2016. Methods: A literature search was conducted during December 2017 using the Cumulative Index of Nursing and Allied Health, Excerpta Medica database, MEDLINE, PubMed, and the Cochrane Library. Keywords used were pressure injury(ies), pressure ulcer, pressure ulcers, decubitus ulcer, and decubitus ulcers. Articles were excluded if published before 2006, patients were adolescents or adults, and if injuries were not caused by PIVC-associated limb-splinting. Patients included in the case series were identified through screening of admissions in one ward of a tertiary paediatric hospital. Results: Five low-quality studies were included in the literature review. Three children were included in the case series. Each child acquired a PI subsequent to limb-splinting and taping adjacent to a PIVC. Hydration, nutritional state, and oxygenation did not appear to contribute to PI development in these cases. Conclusions: There is a gap in the evidence base pertaining to PIVC splinting and its involvement with PI formation in neonates, infants, and children. The existing literature provides low-quality evidence this problem exists; thus, further research is recommended.


Dermatology ◽  
2018 ◽  
Vol 234 (3-4) ◽  
pp. 79-85 ◽  
Author(s):  
Zarqa Ali ◽  
Charlotte Suppli Ulrik ◽  
Tove Agner ◽  
Simon Francis Thomsen

Atopic dermatitis (AD) may be associated with the metabolic syndrome and by that carry an increased risk of cardio­vascular disease. Our objective was to provide an update on current knowledge of the association between AD and metabolic syndrome, including each component of the metabolic syndrome. A systematic literature review was performed to identify studies investigating the association between metabolic syndrome and AD from PubMed, Embase, and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A total of 14 studies, investigating the association between AD and the metabolic syndrome or AD and components of metabolic syndrome fulfilled the inclusion criteria and were included. It seems unlikely that the association between AD and metabolic syndrome is causal. However, women with AD tended to have components of metabolic syndrome more often than women without AD. There was a positive association between AD and central obesity measured as waist circumference, and this association was stronger for women than men. Despite conflicting results regarding hypertension, the association between hypertension and AD also appeared stronger for women. On the other hand, the association between AD and hyperglycemia appears unlikely, and the association between AD and cholesterol levels was inconsistent. In conclusion, it remains unclear whether AD is a risk factor for metabolic syndrome and its components. However, data indicate that central obesity is associated with AD and that the association is stronger for women than men.


2021 ◽  
Vol 10 (9) ◽  
pp. e21110917814
Author(s):  
Hadassa Fonsêca da Silva ◽  
Alice Pinho André Gomes Morais ◽  
Guilherme Marinho Sampaio ◽  
Gabriel Henrique Queiroz Oliveira ◽  
Paulo Melo Júnior ◽  
...  

Background: Endodontic Regenerative Procedures, especially pulp revascularization therapy, have become a real option for the treatment for immature permanent teeth with open apices. This sort of approach has saved many teeth that otherwise would have been extracted. The technique is simple and effective, and can be accomplished by any odontologist. Objective: This article aimed to make a literature review to give support for a case report of an Endodontic Regenerative Procedure of a twelve-year-old male patient with immature open apice of tooth 21. Methodology: Articles were researched concerning pulp revascularization to reach root end formation. On line searches were accomplished, whose database include BVS/BIREME, Web of Science, PUBMED Central, Science Direct, Higher Level Personnel Improvement Coordinator (CAPES), The Cochrane Library, and PROSPERO). Results: the articles researched showed that Endodontic Regenerative Procedures are efficient in stimulating root end formation. The case report described matched the results offered by the articles, showing an immature open apice tooth that had its root end completely formed after pulp revascularization therapy. Conclusion: Pulp revascularization therapy is an efficient and practical treatment for immature teeth with open apices.


BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021322 ◽  
Author(s):  
Iosief Abraha ◽  
Alessandro Montedori ◽  
Gian Carlo Di Renzo ◽  
Patrizio Angelozzi ◽  
Marta Micheli ◽  
...  

IntroductionPatientblood management (PBM) is defined as the application of evidence-based diagnostic, preventive and therapeutic approaches designed to maintain haemoglobin concentration, optimise haemostasis and minimise blood loss in an effort to improve patient outcome. We propose a protocol for the assessment of the evidence of diagnostic, preventive and therapeutic approaches for the management of relevant outcomes in obstetrics with the aim to create a framework for PBM implementation.Methods and analysisDiagnostic, preventive and therapeutic tools will be considered in the gynaecological conditions and obstetrics setting (antenatal care, peripartum care and maternity care). For each condition, (1) clinical questions based on prioritised outcomes will be developed; (2) evidence will be retrieved systematically from electronic medical literature (MEDLINE, EMBASE, the Cochrane Library, Web of Science, and CINAHL); (3) quality of the reviews will be assessed using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklist; quality of primary intervention studies will be assessed using the risk of bias tool (Cochrane method); quality of diagnostic primary studies will be assessed using QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies); (4) the Grading of Recommendations Assessment, Development and Evaluation method will be applied to rate the quality of the evidence and to develop recommendations.Ethics and disseminationFor each diagnostic, preventive or therapeutic intervention evaluated, a manuscript comprising the evidence retrieved and the recommendation produced will be provided and published in peer-reviewed journals. Ethical approval is not required.


2021 ◽  
Vol 6 (2) ◽  
pp. 42
Author(s):  
Rita Chiaramonte ◽  
Piero Pavone ◽  
Michele Vecchio

This systematic review aims to provide an overview of the diagnostic methods, preventive strategies, and therapeutic approaches for cyclists suffering from pudendal neuropathy. The study defines a guide in delineating a diagnostic and therapeutic protocol using the best current strategies. Pubmed, EMBASE, the Cochrane Library, and Scopus Web of Science were searched for the terms: “Bicycling” OR “Bike” OR “Cyclists” AND “Neuropathy” OR “Pudendal Nerve” OR “Pudendal Neuralgia” OR “Perineum”. The database search identified 14,602 articles. After the titles and abstracts were screened, two independent reviewers analyzed 41 full texts. A total of 15 articles were considered eligible for inclusion. Methodology and results of the study were critically appraised in conformity with PRISMA guidelines and PICOS criteria. Fifteen articles were included in the systematic review and were used to describe the main methods used for measuring the severity of pudendal neuropathy and the preventive and therapeutic strategies for nerve impairment. Future research should determine the validity and the effectiveness of diagnostic and therapeutic strategies, their cost-effectiveness, and the adherences of the sportsmen to the treatment.


2018 ◽  
Vol 14 (4) ◽  
pp. 6-13
Author(s):  
Ирина Найданова ◽  
Irina Naidanova ◽  
Юрий Писаревский ◽  
Yurii Pisarevskii ◽  
Алексей Шаповалов ◽  
...  

Introduction. A variety of concepts and approaches to the analysis of the etiology and pathogenesis of temporomandibular joint dysfunctions, results in increased interest in the search for highly informative diagnostic methods, especially at the stage of pre-clinical manifestations. Objectives. The aim of the study was to analyze the possibilities of modern technologies in diagnostics of temporomandibular joint dysfunctions. Materials and methods. We studied original papers on the diagnostics of temporomandibular joint dysfunctions from several databases: Russian State Library, eLibrary, PubMed, The Cochrane Library, Google Scholar. Results. The review presents both generally accepted and alternative approaches to the diagnostics of different clinical manifestations in temporomandibular joint dysfunctions. We described the diagnostic value of occlusal disorders analysis in universal articulators, virtual articulators, T-scan system. Capabilities of teleroentgenography, axiography, electromyography, computed and magnetic resonance imaging were estimated as well. Conclusions. The literature review on the problem of diagnosing the temporomandibular joint dysfunctions showed a scientifically based spectrum of diagnostic capabilities of modern dentistry, a trend in the development of highly informative digital diagnostic technologies. Due to the diversity of the etiology and pathogenesis of the temporomandibular joint dysfunctions further in-depth studies of this issue are required.


2008 ◽  
Vol 64 (2) ◽  
Author(s):  
P. Alakram ◽  
T. Puckree

Facial (VII th cranial nerve) palsy is a condition that affects 1 in 5000 people worldwide. More recently it has appeared as one form of the  neural manifestations  of  infection  by  the Human  Immunodeficiency Virus. As such it is likely that this condition will feature more prominently in the caseload of physiotherapists.  Therefore the purpose of this paper is to present to physiotherapists existing knowledge on the diagnosis, objective assessment and prognosis of  facial palsy  through a  literature  review. All  available  primary  and  secondary  sources  of  literature  were  obtained through a search of Medline, Sabinet, PEDRO, the Cochrane library and a wide Google search. Objective ways of assessing Bells palsy and its recovery as  used  currently  by  the Belly Palsy Association  and  accepted  by  the American Academy  of Otolaryngology  and Head and Neck, are presented together with diagnosis and prognosis.


2019 ◽  
Vol 3 (8) ◽  
pp. 1197-1210 ◽  
Author(s):  
Julia Bohlius ◽  
Kari Bohlke ◽  
Roberto Castelli ◽  
Benjamin Djulbegovic ◽  
Maryam B. Lustberg ◽  
...  

Abstract Purpose: To update the American Society of Clinical Oncology (ASCO)/American Society of Hematology (ASH) recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods: PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs in patients with cancer published from January 31, 2010, through May 14, 2018. For biosimilar ESAs, the literature search was expanded to include meta-analyses and RCTs in patients with cancer or chronic kidney disease and cohort studies in patients with cancer due to limited RCT evidence in the cancer setting. ASCO and ASH convened an Expert Panel to review the evidence and revise previous recommendations as needed. Results: The primary literature review included 15 meta-analyses of RCTs and two RCTs. A growing body of evidence suggests that adding iron to treatment with an ESA may improve hematopoietic response and reduce the likelihood of RBC transfusion. The biosimilar literature review suggested that biosimilars of epoetin alfa have similar efficacy and safety to reference products, although evidence in cancer remains limited. Recommendations: ESAs (including biosimilars) may be offered to patients with chemotherapy-associated anemia whose cancer treatment is not curative in intent and whose hemoglobin has declined to < 10 g/dL. RBC transfusion is also an option. With the exception of selected patients with myelodysplastic syndromes, ESAs should not be offered to most patients with nonchemotherapy-associated anemia. During ESA treatment, hemoglobin may be increased to the lowest concentration needed to avoid transfusions. Iron replacement may be used to improve hemoglobin response and reduce RBC transfusions for patients receiving ESA with or without iron deficiency. Additional information is available at www.asco.org/supportive-care-guidelines and www.hematology.org/guidelines.


2012 ◽  
Vol 16 (5) ◽  
pp. 300-305 ◽  
Author(s):  
Michael Sawchuk ◽  
Frank Spano ◽  
Wei Jing Loo ◽  
Lyn Guenther

Background: Psoriasis and vitiligo are both autoimmune diseases with an increased incidence noted in genetic relatives. They share similar trigger factors and have been observed to coexist in individuals. Objective: The purpose was to review the literature on the coexistence of psoriasis and vitiligo and to determine if there is a higher than expected prevalence of psoriasis in patients with vitiligo and vice versa. Methods: A literature review was conducted using Medline, EMBASE, and the Cochrane Library from 1968 to 2010. All articles that included reports of individuals with both psoriasis and vitiligo in the English language were documented. Results: We identified 338 articles, among which 35 case reports and 7 case series were mentioned. For each case series, the prevalence of psoriasis in patients with vitiligo, or vice versa, falls within the prevalence range of the background population on which the study was based. Conclusion: An increase in the expected prevalence of psoriasis in individuals with vitiligo, or vice versa, was not found in our study, suggesting that the coexistence of the two diseases appears to be due to chance alone. Large epidemiologic studies are required to address with certainty whether psoriasis is more common in individuals with vitiligo and vice versa. Renseignements de base: Le psoriasis et le vitiligo sont deux affections auto-immunes qui ont une incidence accrue observée chez les membres de la famille apparentée. Ils partagent des facteurs déclencheurs similaires, et des études ont démontré leur coexistence chez les personnes. Objectif: Le but était de faire une analyse documentaire sur la coexistence du psoriasis et du vitiligo et de déterminer s'il y a une prévalence plus élevée que prévu du psoriasis chez les patients atteints de vitiligo et vice versa. Méthodes: Une analyse documentaire a été effectuée en utilisant Medline, EMBASE, et la Cochrane Library de 1968 à 2010. Tous les articles comportant des rapports sur des personnes souffrant à la fois de psoriasis et de vitiligo rédigés en anglais ont été documentés. Résultats: Nous avons trouvé 338 articles, parmi lesquels 35 exposés de cas et 7 séries de cas ont été mentionnés. Pour chaque série de cas, la prévalence du psoriasis chez les patients atteints de vitiligo, ou vice versa, s'inscrit dans la fourchette de prévalence de la population de base qui a fait l'objet de l'étude. Conclusion: Notre étude n'a pas démontré une augmentation de la prévalence de psoriasis attendue chez les personnes atteintes de vitiligo, ou vice versa, ce qui suggère que la coexistence des deux affections semble être due au seul hasard. D'importantes études épidémiologiques sont nécessaires pour démontrer avec certitude que le psoriasis est plus fréquent chez les personnes atteintes de vitiligo et vice versa.


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