Nutritional Optic Neuropathies: State of the Art and Emerging Evidences

Nutritional optic neuropathy is a cause of bilateral, symmetrical, and progressive visual impairment with loss of central visual acuity and contrast sensitivity, dyschromatopsia, and a central or centrocecal scotoma. The clinical features are not pathognomonic, since hereditary and toxic forms share similar signs and symptoms. It is becoming increasingly common due to the widespread of bariatric surgery and strict vegetarian or vegan diets, so even the scientific interest has recently increased. In particular, recent studies have focused on possible pathogenetic mechanisms, and on novel diagnostic and therapeutic strategies in order to prevent the onset, make a prompt diagnosis and an accurate nutritional supplementation, and to avoid irreversible optic nerve atrophy. Nowadays, there is clear evidence of the role of cobalamin, folic acid, thiamine, and copper, whereas further studies are needed to define the role of niacin, riboflavin, and pyridoxine. This review aims to summarize the etiology, diagnosis, and treatment of nutritional optic neuropathy, and it is addressed not only to ophthalmologists, but to all physicians who could come in contact with a patient with a possible nutritional optic neuropathy, being a fundamental multidisciplinary approach.

Download Full-text

Controversies on neuroprotection therapy in non-arteritic anterior ischaemic optic neuropathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314656 ◽

2019 ◽

Vol 104 (2) ◽

pp. 153-156

Author(s):

Sohan Singh Hayreh

Keyword(s):

Clinical Trials ◽

Ischaemic Stroke ◽

Optic Neuropathy ◽

Experimental Studies ◽

Therapeutic Strategies ◽

Ischaemic Optic Neuropathy ◽

Pubmed Search ◽

Anterior Ischaemic Optic Neuropathy ◽

Study Designs

ObjectiveThere has long been a great interest in neuroprotection therapy for ischaemic stroke and various types of optic neuropathies. In view of that, I reviewed the literature on the role of neuroprotection for non-arteritic anterior ischaemic optic neuropathy (NA-AION).MethodsThe review is based on a PubMed search of literature about the use of neuroprotectors in stroke and optic neuropathies and about current clinical trials of RPh201 and QPI-1007 in NA-AION.ResultsSeveral neuroprotection agents for ischaemic stroke and various types of optic neuropathies have been evaluated extensively in experimental studies in animals and benefits claimed. However, translation of therapeutic strategies for neuroprotection from experimental research to humans has invariably been fraught with failure. Two currently ongoing studies dealing with neuroprotection by RPh201 and QPI-1007 in NA-AION may have limitations in their rationale and study designs.ConclusionsUnfortunately, in spite of all the experimental and clinical research on neuroprotection agents in NA-AION so far, we have no scientifically proven evidence of neuroprotection agents showing any benefit in the human clinical studies so far.

Download Full-text

Currarino Syndrome in a China children’s health institute: on diagnosis and surgical treatment

10.21203/rs.3.rs-23350/v1 ◽

2020 ◽

Author(s):

Wenbo Pang ◽

Yajun Chen ◽

Chunhui Peng ◽

Kai Wang ◽

Xiang Qi ◽

...

Keyword(s):

Surgical Treatment ◽

Operative Treatment ◽

Multidisciplinary Approach ◽

Clinical Signs ◽

Signs And Symptoms ◽

Bowel Function ◽

Currarino Syndrome ◽

Clinical Signs And Symptoms ◽

Prompt Diagnosis

Abstract Background Currarino syndrome is a rare disease which needs multidisciplinary management. Misdiagnosis with mal-management is common in children. This study was to summarize the clinical features of children diagnosed with Currarino syndrome in a China institute, with an emphasis on diagnosis and surgical treatment, in order to aid in the diagnosis and determination of the optimal operative treatment. Results From 2016 to 2018, seven patients were diagnosed with Currarino syndrome in our department. One patient was male and six were female, with an admission age of 27.00(16.00, 44.00) months. In four patients, diagnosis of the presacral masses had been missed. Ultrasonography, plain sacral radiographs, contrast enemas and magnetic resonance imaging are necessary for the prompt diagnosis of this syndrome. The initial treatment involved a sagittal anorectoplasty and resection of the mass, followed by a defunctioning ostomy and closure of the stoma in a staged multidisciplinary approach. A limited sagittal route was chosen for the surgical treatment in this group. After closure of the ileostomy or colostomy, bowel function was satisfactory in all children. Conclusion Improved knowledge of the different clinical signs and symptoms of Currarino syndrome will result in appropriate imaging and prompt diagnosis. A protocol with rational timing of multidisciplinary surgical procedures may help to avoid undesirable outcomes. The limited sagittal route is available for effective operative treatment.

Download Full-text

Pneumonia and hospitalizations in the elderly

Geriatric Care ◽

10.4081/gc.2017.6377 ◽

2017 ◽

Vol 3 (1) ◽

Author(s):

Francesco Cacciatore ◽

Carlo Gaudiosi ◽

Francesca Mazzella ◽

Anna Scognamiglio ◽

Irene Mattucci ◽

...

Keyword(s):

State Of The Art ◽

Terminally Ill ◽

Signs And Symptoms ◽

The Elderly ◽

Invasive Ventilation ◽

Severe Problem ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Hospital Acquired

Pneumonia in the elderly is a common and severe problem. In this review we analyze the state of the art for pneumonia in the elderly. Several aspects are discussed: i) how common is the disease; signs and symptoms in the elderly; ii) the elderly must always be hospitalized and which is the best place - Intensive Care Unit or medical ward?; iii) the role of comorbidities; iv) etiology and pathogenesis; medical treatment - when and how to start; v) antibiotic resistance; vi) antibiotics in hospital acquired and ventilator related pneumonia; vii) assisted non-invasive ventilation; viii) the treatment in the terminally ill elderly patient.

Download Full-text

The Role of Pro-Resolving Lipid Mediators in Colorectal Cancer-Associated Inflammation: Implications for Therapeutic Strategies

Cancers ◽

10.3390/cancers12082060 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2060

Author(s):

Federica Ungaro ◽

Silvia D’Alessio ◽

Silvio Danese

Keyword(s):

Colorectal Cancer ◽

State Of The Art ◽

Therapeutic Strategies ◽

Lipid Mediators ◽

Adverse Side Effects ◽

Endogenous Lipid ◽

Protein Receptors ◽

Inflammatory Drugs ◽

Inflammatory Milieu

Inflammation is a recognized hallmark of cancer that contributes to the development and progression of colorectal cancer (CRC). Anti-inflammatory drugs currently used for the treatment of CRC show many adverse side effects that prompted researchers to propose the polyunsaturated fatty acids-derived specialized pro-resolving mediators (SPMs) as promoters of resolution of cancer-associated inflammation. SPMs were found to inhibit the CRC-associated pro-inflammatory milieu via specific G-coupled protein receptors, although clinical data are still lacking. This review aims to summarize the state-of-the-art in this field, ultimately providing insights for the development of innovative anti-CRC therapies that promote the endogenous lipid-mediated resolution of CRC-associated inflammation.

Download Full-text

Multiple urethral calculus misdiagnosed as urethral stricture: The role of imaging in unknotting the confusion

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i3.13874 ◽

2016 ◽

Vol 7 (3) ◽

pp. 118-120

Author(s):

M. Danfulani ◽

S.A. Saidu ◽

M.A. Musa

Keyword(s):

Urinary Tract ◽

Urethral Stricture ◽

Imaging Modality ◽

Signs And Symptoms ◽

Upper Urinary Tract ◽

Urethral Calculus ◽

Urinary Tract Calculi ◽

Urethral Diseases ◽

Prompt Diagnosis

Urinary Tract Calculi Impaction / finding in the male urethra is extremely uncommon and can usually be secondary to upper urinary tract calculus formation or primarily arising from the urethra either due to stricture or post-trauma. There is paucity of urethral stricture report in Nigeria, thus this case is reported to highlight the role of imaging in the prompt diagnosis and management of urethral diseases; and to advise urologists to at least always request for imaging modality in their routine evaluation of urethral pathologies. We report a case of a 55 years old male farmer who presented in the Accident and Emergency Unit of our facility with signs and symptoms of acute urinary retention. A working diagnosis of urethral stricture was entertained and prompt diagnosis was made on image. Existing literatures outlining the pathologies, clinical presentation, therapeutic consideration and imaging as it relates to urethral calculi were reviewed. We thus concluded that imaging is very vital and fundamental in order to correctly assess any form of urethral pathology.Asian Journal of Medical Sciences Vol. 7(3) 2016 118-120

Download Full-text

State-of-the-Art: Inflammatory and Metabolic Markers in Mood Disorders

Life ◽

10.3390/life10060082 ◽

2020 ◽

Vol 10 (6) ◽

pp. 82

Author(s):

Federico Mucci ◽

Donatella Marazziti ◽

Alessandra Della Vecchia ◽

Stefano Baroni ◽

Paolo Morana ◽

...

Keyword(s):

Mood Disorders ◽

State Of The Art ◽

Therapeutic Strategies ◽

Metabolic Processes ◽

Metabolic Markers ◽

Comprehensive Review ◽

Immune Systems

Mounting evidence highlights the involvement of inflammatory/immune systems and their relationships with neurotransmitters and different metabolic processes in mood disorders. Nevertheless, there is a general agreement that available findings are still inconclusive. Therefore, further investigations are required, aimed at deepening the role of possible alterations of biomarkers in the pathophysiology of mood disorders that might lead to more focused and tailored treatments. The present study is a comprehensive review on these topics that seem to represent intriguing avenues for the development of real innovative therapeutic strategies of mood disorders.

Download Full-text