scholarly journals Functional Constipation and the Gut Microbiome in Children: Preclinical and Clinical Evidence

2021 ◽  
Vol 8 ◽  
Author(s):  
David Avelar Rodriguez ◽  
Jelena Popov ◽  
Elyanne M. Ratcliffe ◽  
Erick Manuel Toro Monjaraz
Keyword(s):  
Gut Microbiome ◽  
Potential Role ◽  
Clinical Evidence ◽  
Clinical Presentation ◽  
Functional Constipation ◽  
Conventional Management ◽  
Bowel Movements ◽  
Preclinical And Clinical Studies

Functional constipation is a common condition in childhood with significant impact on patients' quality of life and on health care resources. Functional constipation is characterized by decreased bowel movements and/or hard stools, which cause significant distress for children and their caregivers. While the term “functional” may imply the absence of organic causes with a focus on behavioral aspects, 40% of children continue to have symptoms beyond conventional management with one in four children continuing to experience constipation into adulthood. The refractory and chronic nature of constipation highlights the importance of considering a range of pathophysiological mechanisms, including the potential role of the gut microbiome. In this review, we provide an overview of preclinical and clinical studies that focus on the potential mechanisms through which the gut microbiome might contribute to the clinical presentation of functional constipation in pediatrics.

scholarly journals Preclinical and Clinical Evidence Supporting Use of Cannabidiol in Psychiatry

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Gioacchino Calapai ◽  
Carmen Mannucci ◽  
Ioanna Chinou ◽  
Luigi Cardia ◽  
Fabrizio Calapai ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Potential Role ◽  
Clinical Evidence ◽  
Cannabis Sativa ◽  
Psychiatric Patients ◽  
Mental Diseases ◽  
Schizophrenic Patients ◽  
Major Chemical ◽  
Preclinical And Clinical Studies

Background. Cannabidiol (CBD) is a major chemical compound present in Cannabis sativa. CBD is a nonpsychotomimetic substance, and it is considered one of the most promising candidates for the treatment of psychiatric disorders. Objective. The aim of this review is to illustrate the state of art about scientific research and the evidence of effectiveness of CBD in psychiatric patients. Methods. This review collects the main scientific findings on the potential role of CBD in the psychiatric field, and results of clinical trials carried out on psychiatric patients are commented. A research was conducted in the PUBMED, SCOPUS, and ScienceDirect databases using combinations of the words cannabidiol, psychiatry, and neuropsychiatric. Results. Preclinical and clinical studies on potential role of CBD in psychiatry were collected and further discussed. We found four clinical studies describing the effects of CBD in psychiatric patients: two studies about schizophrenic patients and the other two studies carried out on CBD effects in patients affected by generalized social anxiety disorder (SAD). Conclusion. Results from these studies are promising and suggest that CBD may have a role in the development of new therapeutic strategies in mental diseases, and they justify an in-depth commitment in this field. However, clinical evidence we show for CBD in psychiatric patients is instead still poor and limited to schizophrenia and anxiety, and it needs to be implemented with further studies carried out on psychiatric patients.

scholarly journals Women's COPD

2022 ◽  
Vol 8 ◽  
Author(s):  
Maéva Zysman ◽  
Chantal Raherison-Semjen
Keyword(s):  
Disease Management ◽  
Pulmonary Rehabilitation ◽  
Clinical Presentation ◽  
Chronic Obstructive ◽  
Specific Population ◽  
Obstructive Pulmonary Disease ◽  
Medical Consultations ◽  
The Usa

Chronic obstructive pulmonary disease (COPD) is no longer a respiratory disease that predominantly affects men, to the point where the prevalence among women has equaled that of men since 2008, partly due to their increasing exposure to tobacco and to biomass fuels. Indeed, COPD has become the leading cause of death in women in the USA. A higher susceptibility of female to smoking and pollutants could explain this phenomenon. Besides, the clinical presentation appears different among women with more frequent breathlessness, anxiety or depression, lung cancer (especially adenocarcinoma), undernutrition and osteoporosis. Quality of life is also more significantly impaired in women. The theories advanced to explain these differences involve the role of estrogens, smaller bronchi, impaired gas exchange in the lungs and smoking habits. Usual medications (bronchodilators, ICS) demonstrated similar trends for exacerbation prevention and lung function improvement in men and women. There is an urgent need to recognize the increasing burden of COPD in women and therefore to facilitate global improvements in disease management (smoking cessation, pulmonary rehabilitation…) in half of the population. Nevertheless, important limitations to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. In conclusion there is an urgent need to recognize the increasing burden of COPD in women and therefore to facilitate globally improvements in disease management in this specific population.

scholarly journals The Expanding Role of Real-World Evidence Trials in Health Care Decision Making

2019 ◽  
Vol 14 (1) ◽  
pp. 174-179 ◽  
Author(s):  
David C. Klonoff
Keyword(s):  
Real World ◽  
Clinical Evidence ◽  
Real World Data ◽  
Medical Products ◽  
Advantages And Disadvantages ◽  
Randomized Controlled ◽  
Real World Evidence ◽  
Care Decision

Real-world evidence (RWE) is the clinical evidence about benefits or risks of medical products derived from analyzing real world data (RWD), which are data collected through routine clinical practice. This article discusses the advantages and disadvantages of RWE studies, how these studies differ from randomized controlled trials (RCTs), how to overcome barriers to current skepticism about RWE, how FDA is using RWE, how to improve the quality of RWE, and finally the future of RWE trials.

scholarly journals Tumor Angiogenesis as a Target for Dietary Cancer Prevention

2012 ◽  
Vol 2012 ◽  
pp. 1-23 ◽  
Author(s):  
William W. Li ◽  
Vincent W. Li ◽  
Michelle Hutnik ◽  
Albert S. Chiou
Keyword(s):  
Quality Of Life ◽  
Cancer Prevention ◽  
Healthcare Costs ◽  
Clinical Evidence ◽  
Advanced Malignancies ◽  
Antiangiogenic Drugs ◽  
Novel Strategy ◽  
Kidney Liver

Between 2000 and 2050, the number of new cancer patients diagnosed annually is expected to double, with an accompanying increase in treatment costs of more than $80 billion over just the next decade. Efficacious strategies for cancer prevention will therefore be vital for improving patients' quality of life and reducing healthcare costs. Judah Folkman first proposed antiangiogenesis as a strategy for preventing dormant microtumors from progressing to invasive cancer. Although antiangiogenic drugs are now available for many advanced malignancies (colorectal, lung, breast, kidney, liver, brain, thyroid, neuroendocrine, multiple myeloma, myelodysplastic syndrome), cost and toxicity considerations preclude their broad use for cancer prevention. Potent antiangiogenic molecules have now been identified in dietary sources, suggesting that a rationally designed antiangiogenic diet could provide a safe, widely available, and novel strategy for preventing cancer. This paper presents the scientific, epidemiologic, and clinical evidence supporting the role of an antiangiogenic diet for cancer prevention.

Is compressive load a factor in the development of tendinopathy?

2011 ◽  
Vol 46 (3) ◽  
pp. 163-168 ◽  
Author(s):  
JL Cook ◽  
C Purdam
Keyword(s):  
Potential Role ◽  
Clinical Evidence ◽  
Compressive Load ◽  
Tensile Load ◽  
Load Management ◽  
Collagen Structure ◽  
Pathological Changes ◽  
Compressive Loads ◽  
Excessive Load

Tendons are designed to take tensile load, but excessive load can cause overuse tendinopathy. Overuse tendinopathy results in extensive changes to the cells and extracellular matrix, resulting in activated cells, increase in large proteoglycans and a breakdown of the collagen structure. Within these pathological changes, there are areas of fibrocartilaginous metaplasia, and mechanotransduction models suggest that this response could be due to compressive load. As load management is a cornerstone of treating overuse tendinopathy, defining the effect of tensile and compressive loads is important in optimising the clinical management of tendinopathy.This paper examines the potential role of compressive loads in the onset and perpetuation of tendinopathy, and reviews the anatomical, epidemiological and clinical evidence that supports consideration of compressive loads in overuse tendinopathy.

scholarly journals COVID-19: Potential role of prophylactic anticoagulation in preventing thrombotic events and mortality. Narrative review

2021 ◽  
Vol 3 (2) ◽  
pp. 122-129
Author(s):  
Maximiliano Gabriel Castro ◽  
◽  
Gisel Cuevas ◽  
Keyword(s):  
Potential Role ◽  
Clinical Evidence ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Narrative Review ◽  
Randomized Controlled ◽  
Prophylactic Dose ◽  
Published Evidence ◽  
Prophylactic Anticoagulation

The COVID-19 pandemic and the limited therapeutic arsenal available strain daily clinical practice. Guidelines have recently recommended routine anticoagulation of hospitalized COVID-19 patients. However, apart from the expert panels’ experience, the provenance of this recommendation is not clear, due to the scarce published evidence. We provide a narrative review with the objective of unraveling the rationale for this practice. First, we analyze the biochemical, histopathological and clinical evidence for a pro-thrombotic profile in COVID-19 patients. Then, we present the clinical data from previous studies and discuss to what extent they aid in clinical decision-making. We conclude that, in the absence of randomized controlled trials, which are of utmost importance, prophylactic-dose anticoagulation should be offered to critically ill patients hospitalized for COVID-19 pneumonia, particularly those with high d-dimer levels, since they are the population most likely to benefit from it.

The Potential Role of Tomudex in the Treatment of Advanced Colorectal Cancer

1997 ◽  
Vol 83 (2) ◽  
pp. 576-580 ◽  
Author(s):  
Alberto F. Sobrero
Keyword(s):  
Colorectal Cancer ◽  
Treatment Outcome ◽  
Potential Role ◽  
Advanced Colorectal Cancer ◽  
Toxicity Profile ◽  
Pros And Cons ◽  
Synthase Inhibitor ◽  
Near Future

Aims and Background The quinazoline folate analog thymidylate synthase inhibitor, Tomudex, is about to enter the Italian pharmaceutical market. Its place among the therapeutic options for advanced colorectal cancer is discussed. Methods The pros and cons of currently available chemotherapeutic regimens are briefly described with special attention to patient's and tumor's determinants of treatment outcome. The mechanism of action and the results of phase I, II and III studies of Tomudex are reviewed. Results Not all patients need to be treated. Guidelines are given in this respect. Tomudex at the dose of 3 mg/m2 given i.v. every three weeks has antitumor activity similar to that of currently available regimens, with a favorable toxicity profile. Conclusions Current research approaches are unlikely to dramatically improve the treatment outcome of this disease in the near future. What can reasonably be expected is less toxicity and more convenient routes and schedules of drug administration that may translate into better quality of life for our patients. Tomudex has been devised along these lines.

Potential role of bioactive lipids in rheumatoid arthritis

2021 ◽  
Vol 27 ◽  
Author(s):  
Wheeler Torres ◽  
Mervin Chávez-Castillo ◽  
José L. Peréz-Vicuña ◽  
Rubén Carrasquero ◽  
María P. Díaz ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Potential Role ◽  
The Body ◽  
Omega 3 ◽  
Bioactive Lipids ◽  
Dietary Interventions ◽  
Complex Disorder ◽  
Inflammatory Autoimmune Disease

: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease, which involves a pathological inflammatory response against articular cartilage in multiple joints throughout the body. It is a complex disorder associated with comorbidities such as depression, lymphoma, osteoporosis and cardiovascular disease (CVD), which significantly deteriorate patients’ quality of life and prognosis. This has ignited a large initiative to elucidate the physiopathology of RA, aiming to identify new therapeutic targets and approaches in its multidisciplinary management. Recently, various lipid bioactive products have been proposed to have an essential role in this process; including eicosanoids, specialized pro-resolving mediators, phospholipids/sphingolipids, and endocannabinoids. Dietary interventions using omega-3 polyunsaturated fatty acids or treatment with synthetic endocannabinoids agonists have been shown to significantly ameliorate RA symptoms. Indeed, the modulation of lipid metabolism may be crucial in the pathophysiology and treatment of autoimmune diseases.

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