scholarly journals Metabolomics in Central Sensitivity Syndromes

Metabolites ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 164 ◽  
Author(s):  
Joseph S. Miller ◽  
Luis Rodriguez-Saona ◽  
Kevin V. Hackshaw
Keyword(s):  
Small Molecules ◽  
Central Sensitization ◽  
Metabolic Pathways ◽  
Treatment Options ◽  
Case Series ◽  
Opiate Abuse ◽  
Current State ◽  
Increased Risk ◽  
Adults And Children

Central sensitization syndromes are a collection of frequently painful disorders that contribute to decreased quality of life and increased risk of opiate abuse. Although these disorders cause significant morbidity, they frequently lack reliable diagnostic tests. As such, technologies that can identify key moieties in central sensitization disorders may contribute to the identification of novel therapeutic targets and more precise treatment options. The analysis of small molecules in biological samples through metabolomics has improved greatly and may be the technology needed to identify key moieties in difficult to diagnose diseases. In this review, we discuss the current state of metabolomics as it relates to central sensitization disorders. From initial literature review until Feb 2020, PubMed, Embase, and Scopus were searched for applicable studies. We included cohort studies, case series, and interventional studies of both adults and children affected by central sensitivity syndromes. The majority of metabolomic studies addressing a CSS found significantly altered metabolites that allowed for differentiation of CSS patients from healthy controls. Therefore, the published literature overwhelmingly supports the use of metabolomics in CSS. Further research into these altered metabolites and their respective metabolic pathways may provide more reliable and effective therapeutics for these syndromes.

scholarly journals Methodological quality and synthesis of case series and case reports

2018 ◽  
Vol 23 (2) ◽  
pp. 60-63 ◽  
Author(s):  
Mohammad Hassan Murad ◽  
Shahnaz Sultan ◽  
Samir Haffar ◽  
Fateh Bazerbachi
Keyword(s):  
Methodological Quality ◽  
Medical Literature ◽  
Case Reports ◽  
Case Series ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Study Designs ◽  
Inform Decision Making

Case reports and case series are uncontrolled study designs known for increased risk of bias but have profoundly influenced the medical literature and continue to advance our knowledge. In this guide, we present a framework for appraisal, synthesis and application of evidence derived from case reports and case series. We propose a tool to evaluate the methodological quality of case reports and case series based on the domains of selection, ascertainment, causality and reporting and provide signalling questions to aid evidence-based practitioners and systematic reviewers in their assessment. We suggest using evidence derived from case reports and case series to inform decision-making when no other higher level of evidence is available.

The Effectiveness of Autologous Conditioned Serum in the Treatment of Knee Osteoarthritis

2014 ◽  
Vol 23 (4) ◽  
pp. 365-369 ◽  
Author(s):  
Matthew Astolfi ◽  
Kelly McGuire ◽  
Thomas W. Kaminski
Keyword(s):  
Treatment Options ◽  
Previous History ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Knee Oa ◽  
Autologous Conditioned Serum ◽  
Increased Risk ◽  
History Of ◽  
Quality Of Living

Clinical Scenario:Osteoarthritis (OA) is a debilitating degenerative disease affecting an estimated 27 million Americans. A systematic review found that patients with a previous history of traumatic knee injury are at increased risk of developing knee OA, regardless of specific injury. It is vital for the maintenance of quality of life for individuals affected with OA that the treatment options available be able to reduce symptoms and restore quality of living. The pain-relief benefits of traditional injection treatments are small to moderate and have a limited duration. It was found that at 2 wk postinjection that corticosteroids were more effective than hyaluronic acid (HA) injections. Autologous conditioned serum (ACS) injection is a novel treatment that has shown favorable results. However, many clinicians continue to use HA injections for reduction of symptoms in patients with osteoarthritis when the use of ACS may be more beneficial.Focused Clinical Question:For patients with knee OA, is an ACS injection more efficient at producing a reduction in symptoms than HA or a saline injection?

scholarly journals Parosmia due to COVID-19 Disease: A 268 Case Series

2021 ◽  
Author(s):  
Rasheed Ali Rashid ◽  
Ameer A. Alaqeedy ◽  
Raid M. Al-Ani
Keyword(s):  
Recovery Rate ◽  
Clinical Characteristics ◽  
Treatment Options ◽  
Smoking Habit ◽  
Case Series ◽  
Term Treatment ◽  
Clinical Aspects ◽  
Short Term Treatment ◽  
Odor Group

Abstract Although parosmia is a common problem in the era of the COVID-19 pandemic, few studies assessed the demographic and clinical aspects of this debilitating symptom. We aimed to evaluate the socio-clinical characteristics and outcome of various options of treatment of individuals with parosmia due to COVID-19 infection. The study was conducted at two main Hospitals in the Ramadi and Tikrit cities, Iraq, on patients with a chief complaint of parosmia due to COVID-19 disease. The study involved 7 months (August 2020-February 2021). Detailed demographic and clinical characteristics and treatment options with their outcome were recorded and analyzed. Out of 268 patients with parosmia, there were 197 (73.5%) females. The majority were from age group ≤ 30 years (n = 188, 70.1%), housewives (n = 150, 56%), non-smokers (n = 222, 82.8%), and associated with dysgeusia (n = 207, 77.2%) but not associated with nasal symptoms (n = 266, 99.3%). All patients have complained of anosmia (89.9%) or hyposmia (10.1%). Troposmia was reported in the majority of participants. The majority of the patients were suffering from severe parosmia (65.7%). Around 3 quarters of the cases were presented in ≤ 4 months. Altered quality of life (AQL) was presented in 91.8% of subjects, and there was a significant association with the presence of dysgeusia and type and severity of parosmia. The smoking habit didn't show a significant association with AQL, the severity of parosmia, and the recovery rate. Most of the odor group was the most triggering stimuli eliciting parosmia, while, the sewage was the response odor in above 50% of the cases. The recovery rate was poor with olfactory training plus either tonics or local and systemic steroids. Parosmia due to COVID-19 infection is a common problem with poor results in the short-term treatment and follow-up. The AQL was seen in a greater proportion of patients and strongly associated with the presence of dysgeusia, type, and severity of parosmia.

The role of general surgery in the palliative care of patients with cancer

2015 ◽  
Author(s):  
Brian Badgwell ◽  
Robert S. Krouse
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Symptom Control ◽  
Palliative Surgery ◽  
Common Symptom ◽  
Life Outcomes ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Patient Reported

Palliative surgery is defined as surgical intervention in patients with incurable malignancy for symptoms attributable to their cancer. A considerable percentage of consultations at major cancer centres are palliative in nature, resulting in 13-21% of all operations meeting the criteria for palliative surgery. Common symptom groups for evaluation include gastrointestinal obstruction, wound problems/infections, gastrointestinal bleeding, and obstructive jaundice. This chapter outlines the indications, treatment options, and outcomes for these diagnoses and a few less common indications for surgical consultation. Clinical trials are infrequent in this population and there is a paucity of prospective studies with quality of life outcomes measures. Most studies focus on morbidity and mortality as palliative surgery has long been recognized as having increased risk for complications, although recent studies suggest an improvement in this regard. The benefits of palliative surgery should focus on quality of life, symptom control, and symptom prevention. Future studies will be needed to determine the definitions of success and hopefully include patient-reported outcomes assessment.

scholarly journals The Scarcity of Literature on the Psychological, Social, and Emotional Effects of Gastroparesis in Children

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 115
Author(s):  
Tiffany H. Taft ◽  
Bethany Doerfler ◽  
Emily Edlynn ◽  
Linda Nguyen
Keyword(s):  
Pediatric Patients ◽  
Significant Risk ◽  
Future Research ◽  
Social And Emotional ◽  
Current State ◽  
Increased Risk ◽  
Psychosocial Impacts ◽  
Future Research Directions ◽  
State Of Research

Gastroparesis (GP) is a chronic, gastric dysmotility disorder with significant morbidity and mortality. The hallmark of GP is the delayed emptying of the contents of the stomach in the absence of any mechanical obstruction. Patients most commonly report chronic symptoms of nausea, vomiting, feeling full quickly when eating, bloating, and abdominal pain. Treatments are limited with relatively poor efficacy. As such, children with GP are at significant risk for the development of psychological co-morbidities. In this paper, we provide a topical review of the scientific literature on the psychological, social, and emotional impacts of gastroparesis in pediatric patients. We aim to document the current state of research, identify gaps in our knowledge with appropriate recommendations for future research directions, and highlight the unique challenges pediatric patients with GP and their families may face as they manage this disease. Based on the current review, research into the psychosocial impacts in children with GP is essentially non-existent. However, when considering research in children with other chronic digestive diseases, children with GP are likely to face multiple psychosocial challenges, including increased risk for anxiety and depression, stigma, and reduced quality of life. These significant gaps in the current understanding of effects of GP across domains of childhood functioning allow for ample opportunities for future studies to address psychosocial outcomes.

scholarly journals Pulmonary hypertension in chronic lung disease and hypoxia

2019 ◽  
Vol 53 (1) ◽  
pp. 1801914 ◽  
Author(s):  
Steven D. Nathan ◽  
Joan A. Barbera ◽  
Sean P. Gaine ◽  
Sergio Harari ◽  
Fernando J. Martinez ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Current State ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Oxygen Requirements ◽  
Impaired Quality

Pulmonary hypertension (PH) frequently complicates the course of patients with various forms of chronic lung disease (CLD). CLD-associated PH (CLD-PH) is invariably associated with reduced functional ability, impaired quality of life, greater oxygen requirements and an increased risk of mortality. The aetiology of CLD-PH is complex and multifactorial, with differences in the pathogenic sequelae between the diverse forms of CLD. Haemodynamic evaluation of PH severity should be contextualised within the extent of the underlying lung disease, which is best gauged through a combination of physiological and imaging assessment. Who, when, if and how to screen for PH will be addressed in this article, as will the current state of knowledge with regard to the role of treatment with pulmonary vasoactive agents. Although such therapy cannot be endorsed given the current state of findings, future studies in this area are strongly encouraged.

scholarly journals Vitamin K Dependent Proteins in Kidney Disease

2019 ◽  
Vol 20 (7) ◽  
pp. 1571 ◽  
Author(s):  
Ciprian Silaghi ◽  
Tamás Ilyés ◽  
Vladimir Filip ◽  
Marius Farcaș ◽  
Adriana van Ballegooijen ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Vitamin K ◽  
Specific Protein ◽  
Poor Quality ◽  
Matrix Gla Protein ◽  
Future Research ◽  
Current State ◽  
Increased Risk ◽  
Calcification Inhibitors

Patients with chronic kidney disease (CKD) have an increased risk of developing vascular calcifications, as well as bone dynamics impairment, leading to a poor quality of life and increased mortality. Certain vitamin K dependent proteins (VKDPs) act mainly as calcification inhibitors, but their involvement in the onset and progression of CKD are not completely elucidated. This review is an update of the current state of knowledge about the relationship between CKD and four extrahepatic VKDPs: matrix Gla protein, osteocalcin, growth-arrest specific protein 6 and Gla-rich protein. Based on published literature in the last ten years, the purpose of this review is to address fundamental aspects about the link between CKD and circulating VKDPs levels as well as to raise new topics about how the interplay between molecular weight and charge could influence the modifications of circulating VKDPs at the glomerular level, or whether distinct renal etiologies have effect on VKDPs. This review is the output of a systematic literature search and may open future research avenues in this niche domain.

Mood Disorders and Anxiety in Parkinson’s Disease: Current Concepts

2021 ◽  
Vol 34 (4) ◽  
pp. 280-288
Author(s):  
Hendrik Lintel ◽  
Timothy Corpuz ◽  
Saif-ur-Rahman Paracha ◽  
George T. Grossberg
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mood Disorders ◽  
Treatment Options ◽  
Treatment Modalities ◽  
Anxiety And Depression ◽  
Current State ◽  
Non Motor Symptoms ◽  
Impaired Quality

Mood disorders and anxiety significantly impact the prognosis and disease course of Parkinson’s disease. Non-motor symptoms of Parkinson’s disease such as apathy, anhedonia, and fatigue overlap with diagnostic criteria for anxiety and depression, thus making accurate diagnosis of mood disorders in Parkinson’s disease patients difficult. Furthermore, treatment options for mood disorders can produce motor complications leading to poor adherence and impaired quality of life in Parkinson’s disease patients. This review aims to clarify the current state of diagnostic and treatment options pertaining to anxiety and mood disorders in Parkinson’s disease. It explores both the pharmacologic and non-pharmacologic treatment modalities for various mood disorders in comorbid Parkinson’s disease with a brief discussion of the future outlook of the field given the current state of the literature.

Management of atrial fibrillation and anticoagulant therapies

2017 ◽  
pp. 793-804
Author(s):  
Mark O’Neill ◽  
John Whitaker ◽  
Jonathan Birns ◽  
Matthew Wright
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Treatment Options ◽  
Bleeding Risk ◽  
Ventricular Rate ◽  
Supraventricular Arrhythmia ◽  
Increased Risk ◽  
The Impact ◽  
Careful Documentation

Atrial fibrillation (AF) is a common supraventricular arrhythmia which is commonly found in older adults. It is associated with an increased risk of stroke and has a detrimental effect on quality of life. Management of AF involves an attempt to reduce the increased risk of stroke and to treat the symptoms that result from a high (or low) ventricular rate as well as, in some cases, the atrial rhythm itself. The management of AF involves a comprehensive assessment of a patient’s individual stroke and bleeding risk and a careful documentation of the impact of their symptoms on quality of life. Treatment options range from conservative to highly invasive. Selecting the appropriate combination from the range of options necessitates an understanding of the risks and benefits of each, so that the patient and physician can jointly identify the most appropriate management strategy.

A Hairy Situation: Laser Hair Removal after Oral Reconstruction

2017 ◽  
Vol 127 (3) ◽  
pp. 205-208 ◽  
Author(s):  
Bridget E. Shields ◽  
Molly S. Moye ◽  
Rodrigo Bayon ◽  
Steven M. Sperry ◽  
Karolyn A. Wanat
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Donor Site ◽  
Case Series ◽  
Hair Removal ◽  
Laser Hair Removal ◽  
Nd:Yag Lasers ◽  
Dermatology Clinic ◽  
Flap Repair

Objectives: To present a case series of 4 patients who underwent postoperative hair removal using the long-pulsed Alexandrite or Nd:YAG laser following intraoral cutaneous flap reconstruction. Methods: Patients underwent epilation in dermatology clinic with long-pulsed Alexandrite or Nd:YAG lasers, spaced 8 weeks apart, until hair removal was achieved. Results: All patients achieved improvement in hair removal regardless of initial flap donor site with significant improvement in quality of life and minimal side effects. Conclusions: The long-pulsed Alexandrite and Nd:YAG represent safe and effective treatment options to improve patient quality of life following intraoral flap repair following excision of malignancy.

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