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Archivos Argentinos de Pediatria Oct 2019The recognition of the existence of pain in infants hospitalized in the Neonatal Intensive Care Units makes it necessary to reach consensus on prevention, assessment and...
The recognition of the existence of pain in infants hospitalized in the Neonatal Intensive Care Units makes it necessary to reach consensus on prevention, assessment and treatment strategies. Acute pain produces adverse changes in the short term and chronic pain alters the response systems to stress and impacts on neurodevelopment. The objective of this pain management agreement is to unify criteria of attention of these patients in different situations that generate pain and stress that they face during their hospitalization. There are validated scales to assess pain and guide appropriate strategies for its approach that include measures of comprehensive or nonpharmacological care and pharmacological care that we will review.
Topics: Acute Pain; Chronic Pain; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Neonatology; Pain Management; Pain Measurement; Pain Perception
PubMed: 31833337
DOI: 10.5546/aap.2019.S180 -
Advances in Clinical and Experimental... Nov 2022Laparoscopic cholecystectomy is widely performed because it results in a relatively easier pain management and shorter hospital stay. Although postoperative pain... (Review)
Review
Laparoscopic cholecystectomy is widely performed because it results in a relatively easier pain management and shorter hospital stay. Although postoperative pain following laparoscopic cholecystectomy tends to be less intense compared to that following open cholecystectomy, early discomfort from operation after laparoscopy can be similar or even more intense than after open surgery. Consequently, it remains a source of apparent pain and surgical stress. Thus, proactive pain control is a priority for both patients and doctors. A considerable amount of new research about pain and pain management has been documented in the literature over the last 2 decades. In addition, novel medications and technologies for acute pain control after laparoscopic cholecystectomy have been investigated for patient care. Nevertheless, a significant proportion of patients still have excessively high pain levels after laparoscopic surgery. Acute pain after laparoscopic cholecystectomy is complicated in nature and has multiple causes; therefore, a single treatment modality is rarely sufficient. A combined approach to pain management is often the best option. In this review, the wide range of pharmacotherapeutic agents that have been used to control pain after laparoscopic surgery are critically assessed. The article also focuses on new techniques and medications that have been investigated in recent years to manage pain after laparoscopic surgery as quickly and safely as possible.
Topics: Humans; Cholecystectomy, Laparoscopic; Pain Management; Acute Pain; Length of Stay; Cholecystectomy; Pain, Postoperative
PubMed: 36000879
DOI: 10.17219/acem/151995 -
International Journal of Molecular... May 2020Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory syndrome characterized by prolonged and recurrent episodes... (Review)
Review
Tumor necrosis factor receptor-associated periodic syndrome (TRAPS) is an autosomal dominant autoinflammatory syndrome characterized by prolonged and recurrent episodes of fever, abdominal and/or chest pain, arthralgia, myalgia, and erythematous rash. TRAPS is associated with heterozygous variants in the gene, which encodes the TNFR1 (tumor necrosis factor receptor 1) receptor. Disease-causing variants are found exclusively in the extracellular domain of TNFR1 and affect receptor structure and binding to the TNF ligand. The precise mechanism of the disease is still unclear, but it is thought that intracellular accumulation of misfolded mutant protein leads to endoplasmic reticulum stress and enhanced inflammatory responses through constitutive activation of various immune pathways. Other possible mechanisms contributing to the disease pathogenesis include defective receptor shedding, TNF-induced cell death, production of reactive oxygen species, and autophagy impairment. Patients' leucocytes are hyperresponsive to stimulation and produce elevated levels of proinflammatory cytokines. Systemic autoimmune (AA) amyloidosis is an important cause of morbidity and mortality in TRAPS. Over the last two decades, new therapies have changed the progression and outcome of the disease. In this review, we summarize clinical data from 209 patients with validated pathogenic variants reported in the literature and discuss TRAPS diagnosis, pathogenesis, and treatment options.
Topics: Biomarkers; Disease Management; Disease Susceptibility; Fever; Genetic Predisposition to Disease; Genetic Variation; Hereditary Autoinflammatory Diseases; Humans; Molecular Diagnostic Techniques; Molecular Targeted Therapy; Phenotype; Receptors, Tumor Necrosis Factor, Type I
PubMed: 32380704
DOI: 10.3390/ijms21093263 -
Molecular Cancer Jan 2022Cellular metabolism constitutes a fundamental process in biology. During tumor initiation and progression, each cellular component in the cancerous niche undergoes... (Review)
Review
Cellular metabolism constitutes a fundamental process in biology. During tumor initiation and progression, each cellular component in the cancerous niche undergoes dramatic metabolic reprogramming, adapting to a challenging microenvironment of hypoxia, nutrient deprivation, and other stresses. While the metabolic hallmarks of cancer have been extensively studied, the metabolic states of the immune cells are less well elucidated. Here we review the metabolic disturbance and fitness of the immune system in the tumor microenvironment (TME), focusing on the impact of oncometabolites to the function of immune cells and the clinical significance of targeting metabolism in anti-tumor immunotherapy. Metabolic alterations in the immune system of TME offer novel therapeutic insight into cancer treatment.
Topics: Adaptation, Biological; Animals; Cell Transformation, Neoplastic; Cellular Reprogramming; Combined Modality Therapy; Disease Management; Disease Susceptibility; Energy Metabolism; Humans; Immune System; Immunomodulation; Immunotherapy; Neoplasms; Treatment Outcome; Tumor Microenvironment
PubMed: 35062950
DOI: 10.1186/s12943-021-01486-5 -
Blood Oct 2019T-cell prolymphocytic leukemia (T-PLL) is a rare, mature T-cell neoplasm with a heterogeneous clinical course. With the advent of novel treatment options that will... (Review)
Review
T-cell prolymphocytic leukemia (T-PLL) is a rare, mature T-cell neoplasm with a heterogeneous clinical course. With the advent of novel treatment options that will potentially change the management of patients with T-PLL, it has become necessary to produce consensus guidelines for the design and conduct of clinical trials. The T-PLL International Study group (TPLL-ISG) set out to define standardized criteria for diagnosis, treatment indication, and evaluation of response. These criteria will facilitate comparison of results from clinical trials in T-PLL, and will thus support clinical decision making, as well as the approval of new therapeutics by healthcare authorities.
Topics: Bone Marrow; Disease Management; Gene Expression Regulation, Leukemic; Humans; Immunophenotyping; Leukemia, Prolymphocytic, T-Cell; Mutation; Neoplasm Staging; T-Lymphocytes
PubMed: 31292114
DOI: 10.1182/blood.2019000402 -
Cellular and Molecular Life Sciences :... Jan 2020Infertility is a global health problem involving about 15% of couples. Approximately half of the infertility cases are related to male factors. The oxidative stress,... (Review)
Review
Infertility is a global health problem involving about 15% of couples. Approximately half of the infertility cases are related to male factors. The oxidative stress, which refers to an imbalance in levels of reactive oxygen species (ROS) and antioxidants, is one of the main causes of infertility in men. A small amount of ROS is necessary for the physiological function of sperm including the capacitation, hyperactivation and acrosomal reaction. However, high levels of ROS can cause infertility through not only by lipid peroxidation or DNA damage but inactivation of enzymes and oxidation of proteins in spermatozoa. Oxidative stress (OS) is mainly caused by factors associated with lifestyle. Besides, immature spermatozoa, inflammatory factors, genetic mutations and altering levels of sex hormones are other main source of ROS. Since OS occurs due to the lack of antioxidants and its side effects in semen, lifestyle changes and antioxidant regimens can be helpful therapeutic approaches to overcome this problem. The present study aimed to describe physiological ROS production, roles of genetic and epigenetic factors on the OS and male infertility with various mechanisms such as lipid peroxidation, DNA damage, and disorder of male hormone profile, inflammation, and varicocele. Finally, the roles of oral antioxidants and herbs were explained in coping with OS in male infertility.
Topics: Animals; Antioxidants; Disease Management; Humans; Infertility, Male; Male; Oxidative Stress; Reactive Oxygen Species; Spermatozoa
PubMed: 31377843
DOI: 10.1007/s00018-019-03253-8 -
International Journal of Molecular... Jan 2021This is a short review of the basic molecular mechanisms of ovarian aging, written with a particular focus on the use of this data to improve the diagnostic and... (Review)
Review
This is a short review of the basic molecular mechanisms of ovarian aging, written with a particular focus on the use of this data to improve the diagnostic and therapeutic protocols both for women affected by physiological (age-related) ovarian decay and for those suffering premature ovarian insufficiency. Ovarian aging has a genetic basis that conditions the ovarian activity via a plethora of cell-signaling pathways that control the functions of different types of cells in the ovary. There are various factors that can influence these pathways so as to reduce their efficiency. Oxidative stress, often related to mitochondrial dysfunction, leading to the apoptosis of ovarian cells, can be at the origin of vicious circles in which the primary cause feeds back other abnormalities, resulting in an overall decline in the ovarian activity and in the quantity and quality of oocytes. The correct diagnosis of the molecular mechanisms involved in ovarian aging can serve to design treatment strategies that can slow down ovarian decay and increase the quantity and quality of oocytes that can be obtained for an in vitro fertilization attempt. The available treatment options include the use of antioxidants, melatonin, growth hormones, and mitochondrial therapies. All of these treatments have to be considered in the context of each couple's history and current clinical condition, and a customized (patient-tailored) treatment protocol is to be elaborated.
Topics: Aging; Animals; Apoptosis; Disease Management; Female; Humans; Mitochondria; Mutation; Ovary; Oxidative Stress; Primary Ovarian Insufficiency
PubMed: 33573050
DOI: 10.3390/ijms22031371 -
Respirology (Carlton, Vic.) Dec 2019Despite silica dust exposure being one of the earliest recognized causes of lung disease, Australia, USA, Israel, Turkey and other countries around the world have... (Review)
Review
Despite silica dust exposure being one of the earliest recognized causes of lung disease, Australia, USA, Israel, Turkey and other countries around the world have recently experienced significant outbreaks of silicosis. These outbreaks have occurred in modern industries such as denim jean production, domestic benchtop fabrication and jewellery polishing, where silica has been introduced without recognition and control of the hazard. Much of our understanding of silica-related lung disease is derived from traditional occupations such as mining, whereby workers may develop slowly progressive chronic silicosis. However, workers in modern industries are developing acute and accelerated silicosis over a short period of time, due to high-intensity silica concentrations, oxidative stress from freshly fractured silica and a rapid pro-inflammatory and pro-fibrotic response. Appropriate methods of screening and diagnosis remain unclear in these workers, and a significant proportion may go on to develop respiratory failure and death. There are no current effective treatments for silicosis. For those with near fatal respiratory failure, lung transplantation remains the only option. Strategies to reduce high-intensity silica dust exposure, enforced screening programmes and the identification of new treatments are urgently required.
Topics: Disease Management; Dust; Global Health; Humans; Occupational Exposure; Occupational Health; Silicon Dioxide; Silicosis
PubMed: 31517432
DOI: 10.1111/resp.13695 -
International Journal of Molecular... Feb 2021Cancer cachexia (CC) is a multifactorial syndrome in patients with advanced cancer characterized by weight loss via skeletal-muscle and adipose-tissue atrophy, catabolic... (Review)
Review
Cancer cachexia (CC) is a multifactorial syndrome in patients with advanced cancer characterized by weight loss via skeletal-muscle and adipose-tissue atrophy, catabolic activity, and systemic inflammation. CC is correlated with functional impairment, reduced therapeutic responsiveness, and poor prognosis, and is a major cause of death in cancer patients. In colorectal cancer (CRC), cachexia affects around 50-61% of patients, but remains overlooked, understudied, and uncured. The mechanisms driving CC are not fully understood but are related, at least in part, to the local and systemic immune response to the tumor. Accumulating evidence demonstrates a significant role of tumor microenvironment (TME) cells (e.g., macrophages, neutrophils, and fibroblasts) in both cancer progression and tumor-induced cachexia, through the production of multiple procachectic factors. The most important role in CRC-associated cachexia is played by pro-inflammatory cytokines, including the tumor necrosis factor α (TNFα), originally known as cachectin, Interleukin (IL)-1, IL-6, and certain chemokines (e.g., IL-8). Heterogeneous CRC cells themselves also produce numerous cytokines (including chemokines), as well as novel factors called "cachexokines". The tumor microenvironment (TME) contributes to systemic inflammation and increased oxidative stress and fibrosis. This review summarizes the current knowledge on the role of TME cellular components in CRC-associated cachexia, as well as discusses the potential role of selected mediators secreted by colorectal cancer cells in cooperation with tumor-associated immune and non-immune cells of tumor microenvironment in inducing or potentiating cancer cachexia. This knowledge serves to aid the understanding of the mechanisms of this process, as well as prevent its consequences.
Topics: Adipose Tissue; Animals; Autophagy; Biomarkers; Cachexia; Cancer-Associated Fibroblasts; Cell Communication; Colorectal Neoplasms; Cytokines; Disease Management; Disease Susceptibility; Humans; Inflammation Mediators; Muscle, Skeletal; Signal Transduction; Stromal Cells; Tumor Microenvironment
PubMed: 33557173
DOI: 10.3390/ijms22041565 -
International Journal of Molecular... Jan 2021Every organism has an intrinsic biological rhythm that orchestrates biological processes in adjusting to daily environmental changes. Circadian rhythms are maintained by... (Review)
Review
Every organism has an intrinsic biological rhythm that orchestrates biological processes in adjusting to daily environmental changes. Circadian rhythms are maintained by networks of molecular clocks throughout the core and peripheral tissues, including immune cells, blood vessels, and perivascular adipose tissues. Recent findings have suggested strong correlations between the circadian clock and cardiovascular diseases. Desynchronization between the circadian rhythm and body metabolism contributes to the development of cardiovascular diseases including arteriosclerosis and thrombosis. Circadian rhythms are involved in controlling inflammatory processes and metabolisms, which can influence the pathology of arteriosclerosis and thrombosis. Circadian clock genes are critical in maintaining the robust relationship between diurnal variation and the cardiovascular system. The circadian machinery in the vascular system may be a novel therapeutic target for the prevention and treatment of cardiovascular diseases. The research on circadian rhythms in cardiovascular diseases is still progressing. In this review, we briefly summarize recent studies on circadian rhythms and cardiovascular homeostasis, focusing on the circadian control of inflammatory processes and metabolisms. Based on the recent findings, we discuss the potential target molecules for future therapeutic strategies against cardiovascular diseases by targeting the circadian clock.
Topics: Animals; Atherosclerosis; Biomarkers; Circadian Clocks; Circadian Rhythm; Disease Management; Disease Susceptibility; Gene Expression Regulation; Homeostasis; Humans; Molecular Targeted Therapy; Thrombosis; Vascular Diseases
PubMed: 33445491
DOI: 10.3390/ijms22020676