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The International Journal of Social... Aug 2021Grief is a common reaction to the feeling of loss and it is considered a physiological and instinctive response. The 'normal' grief evolves into an 'integrated' phase...
BACKGROUND
Grief is a common reaction to the feeling of loss and it is considered a physiological and instinctive response. The 'normal' grief evolves into an 'integrated' phase within 1 year from death, and it is a non-pathological condition, that do not require specific therapeutic interventions. When this 'integrated phase' does not occur, the subject could reach pathological manifestations related to the grief. The Persistent Complex Bereavement Disorder (PCBD) is a new DSM5 clinical category characterized by symptoms related to the detachment and to the post-traumatic distress and it differs from normal and uncomplicated grief, for the disability caused by these reactions and their persistence and pervasiveness.
AIM
The purpose of this work is the analysis of the pathways that led to this new definition, through a review of the main studies published in the last 20 years, with the aim to clarify the clinical utility of this new diagnostic category.
METHOD
Relevant publications done in the last 20 years were identified via electronic searches of Pubmed, Embase, and Elsevier databases using the terms 'complicated grief' AND 'persistent', according to PRISMA guideline and PICO study design.
RESULTS
PCBD results a new important clinical category showing specific symptoms, diagnostic criteria, and treatment. It presents many differences with other pathologies, that goes into differential diagnosis with PCBD, and it and can be treated with targeted therapeutic approaches. Diagnostic criteria for PCBD could allow an early diagnosis and a correct treatment avoiding underdiagnosis and misdiagnosis.
CONCLUSION
Further researches could focus on the evaluation of more neurobiological aspects, new psychometric tools, for assessing susceptibility to this pathology, and on the cultural aspects that may influence mourning reactions, in an ethno-psychiatric perspective.
Topics: Bereavement; Grief; Humans; International Classification of Diseases; Psychometrics
PubMed: 32972293
DOI: 10.1177/0020764020960202 -
PloS One 2020Recent results have established that masticatory function plays a role not only in the balance of the stomatognathic system and in the central motor control, but also in...
Altered mastication adversely impacts morpho-functional features of the hippocampus: A systematic review on animal studies in three different experimental conditions involving the masticatory function.
Recent results have established that masticatory function plays a role not only in the balance of the stomatognathic system and in the central motor control, but also in the trophism of the hippocampus and in the cognitive activity. These implications have been shown in clinical studies and in animal researches as well, by means of histological, biochemical and behavioural techniques. This systematic review describes the effects of three forms of experimentally altered mastication, namely soft-diet feeding, molar extraction and bite-raising, on the trophism and function of the hippocampus in animal models. Through a systematic search of PubMed, Embase, Web of Science, Scopus, OpenGray and GrayMatters, 645 articles were identified, 33 full text articles were assessed for eligibility and 28 articles were included in the review process. The comprehensiveness of reporting was evaluated with the ARRIVE guidelines and the risk of bias with the SYRCLE RoB tool. The literature reviewed agrees that a disturbed mastication is significantly associated with a reduced number of hippocampal pyramidal neurons in Cornu Ammonis (CA)1 and CA3, downregulation of Brain Derived Neurotrophic Factor (BDNF), reduced synaptic activity, reduced neurogenesis in the Dentate Gyrus (DG), glial proliferation, and reduced performances in behavioural tests, indicating memory impairment and reduced spatial orientation. Moreover, while the bite-raised condition, characterized by occlusal instability, is known to be a source of stress, soft-diet feeding and molar extractions were not consistently associated with a stress response. More research is needed to clarify this topic. The emerging role of chewing in the preservation of hippocampal trophism, neurogenesis and synaptic activity is worthy of interest and may contribute to the study of neurodegenerative diseases in new and potentially relevant ways.
Topics: Animals; Cognition; Dentate Gyrus; Hippocampus; Humans; Mastication; Memory Disorders; Models, Animal; Neurogenesis; Neurons
PubMed: 32817680
DOI: 10.1371/journal.pone.0237872 -
Injury Nov 2020To acquire evidence-based knowledge in temporal and spatial patterns of microglia/macrophages changes to facilitate finding proper intervention time for functional... (Review)
Review
OBJECTIVE
To acquire evidence-based knowledge in temporal and spatial patterns of microglia/macrophages changes to facilitate finding proper intervention time for functional restoration after traumatic spinal cord injury (TSCI).
SETTING
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
METHODS
We searched PubMed and EMBASE via Ovid SP with no temporal and linguistic restrictions. Besides, hand-search was performed in the bibliographies of relevant studies. The experimental non-interventional and non-transgenic animal studies confined to the rat species which assess the pathological change of microglia /macrophages at the specified time were included.
RESULTS
We found 15,315 non-duplicate studies. Screening through title and abstract narrowed down to 607 relevant articles, 31 of them were selected based on the inclusion criteria. The reactivity of the microglia/macrophages initiates in early hours PI in contusion, compression and transection models. Cells activity reached a maximum within 48 h to 28 days in compression, 7 days in contusion and between 4 and 60 days in transection models. Inflammatory response occurred at the epicenter, in or near the lesion site in both gray and white matter in all three injury models with a maximum extension of one centimeter caudal and rostral to the epicenter in the gray matter in contusion and transection models.
CONCLUSION
This study was designed to study spatial-temporal changes in the activation of microglia/macrophages overtime after TSCI. We were able to demonstrate time-dependent cell morphological changes after TSCI. The peak times of cell reactivity and the areas where the cells responded to the injury were determined.
Topics: Animals; Contusions; Disease Models, Animal; Iran; Macrophages; Microglia; Rats; Spinal Cord; Spinal Cord Injuries
PubMed: 32665068
DOI: 10.1016/j.injury.2020.07.007 -
Journal of Orthopaedic Translation Mar 2020Although emerging studies have provided evidence that osteocytes are actively involved in fracture healing, there is a general lack of a detailed understanding of the... (Review)
Review
BACKGROUND
Although emerging studies have provided evidence that osteocytes are actively involved in fracture healing, there is a general lack of a detailed understanding of the mechanistic pathway, cellular events and expression of markers at different phases of healing.
METHODS
This systematic review describes the role of osteocytes in fracture healing from early to late phase. Literature search was performed in PubMed and Embase. Original animal and clinical studies with available English full-text were included. Information was retrieved from the selected studies.
RESULTS
A total of 23 articles were selected in this systematic review. Most of the studies investigated changes of various genes and proteins expression patterns related to osteocytes. Several studies have described a constant expression of osteocyte-specific marker genes throughout the fracture healing cascade followed by decline phase with the progress of healing, denoting the important physiological role of the osteocyte and the osteocyte lacuno-canalicular network in fracture healing. The reports of various markers suggested that osteocytes could trigger coordinated bone healing responses from cell death and expression of proinflammatory markers cyclooxygenase-2 and interleukin 6 at early phase of fracture healing. This is followed by the expression of growth factors bone morphogenetic protein-2 and cysteine-rich angiogenic inducer 61 that matched with the neo-angiogenesis, chondrogenesis and callus formation during the intermediate phase. Tightly controlled regulation of osteocyte-specific markers E11/Podoplanin (E11), dentin matrix protein 1 and sclerostin modulate and promote osteogenesis, mineralisation and remodelling across different phases of fracture healing. Stabilised fixation was associated with the finding of higher number of osteocytes with little detectable bone morphogenetic proteins expressions in osteocytes. Sclerostin-antibody treatment was found to result in improvement in bone mass, bone strength and mineralisation.
CONCLUSION
To further illustrate the function of osteocytes, additional longitudinal studies with appropriate clinically relevant model to study osteoporotic fractures are crucial. Future investigations on the morphological changes of osteocyte lacuno-canalicular network during healing, osteocyte-mediated signalling molecules in the transforming growth factor-beta-Smad3 pathway, perilacunar remodelling, type of fixation and putative biomarkers to monitor fracture healing are highly desirable to bridge the current gaps of knowledge.The translational potential of this article: This systematic review provides an up-to-date chronological overview and highlights the osteocyte-regulated events at gene, protein, cellular and tissue levels throughout the fracture healing cascade, with the hope of informing and developing potential new therapeutic strategies that could improve the timing and quality of fracture healing in the future.
PubMed: 32309136
DOI: 10.1016/j.jot.2019.07.005 -
Current Medical Imaging Reviews 2019To systematically review evidence regarding the association of multiparametric biomarkers with clinical outcomes and their capacity to explain relevant subcompartments...
PURPOSE
To systematically review evidence regarding the association of multiparametric biomarkers with clinical outcomes and their capacity to explain relevant subcompartments of gliomas.
MATERIALS AND METHODS
Scopus database was searched for original journal papers from January 1st, 2007 to February 20th, 2017 according to PRISMA. Four hundred forty-nine abstracts of papers were reviewed and scored independently by two out of six authors. Based on those papers we analyzed associations between biomarkers, subcompartments within the tumor lesion, and clinical outcomes. From all the articles analyzed, the twenty-seven papers with the highest scores were highlighted to represent the evidence about MR imaging biomarkers associated with clinical outcomes. Similarly, eighteen studies defining subcompartments within the tumor region were also highlighted to represent the evidence of MR imaging biomarkers. Their reports were critically appraised according to the QUADAS-2 criteria.
RESULTS
It has been demonstrated that multi-parametric biomarkers are prepared for surrogating diagnosis, grading, segmentation, overall survival, progression-free survival, recurrence, molecular profiling and response to treatment in gliomas. Quantifications and radiomics features obtained from morphological exams (T1, T2, FLAIR, T1c), PWI (including DSC and DCE), diffusion (DWI, DTI) and chemical shift imaging (CSI) are the preferred MR biomarkers associated to clinical outcomes. Subcompartments relative to the peritumoral region, invasion, infiltration, proliferation, mass effect and pseudo flush, relapse compartments, gross tumor volumes, and highrisk regions have been defined to characterize the heterogeneity. For the majority of pairwise cooccurrences, we found no evidence to assert that observed co-occurrences were significantly different from their expected co-occurrences (Binomial test with False Discovery Rate correction, α=0.05). The co-occurrence among terms in the studied papers was found to be driven by their individual prevalence and trends in the literature.
CONCLUSION
Combinations of MR imaging biomarkers from morphological, PWI, DWI and CSI exams have demonstrated their capability to predict clinical outcomes in different management moments of gliomas. Whereas morphologic-derived compartments have been mostly studied during the last ten years, new multi-parametric MRI approaches have also been proposed to discover specific subcompartments of the tumors. MR biomarkers from those subcompartments show the local behavior within the heterogeneous tumor and may quantify the prognosis and response to treatment of gliomas.
Topics: Adult; Bias; Biomarkers, Tumor; Brain Edema; Brain Neoplasms; Cross-Sectional Studies; Glioma; Humans; Magnetic Resonance Imaging; Multiparametric Magnetic Resonance Imaging; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Patient Outcome Assessment; Retrospective Studies; Treatment Outcome; Tumor Burden
PubMed: 32008521
DOI: 10.2174/1573405615666190109100503 -
Experimental Gerontology May 2020Morphological changes of the lumbar spine muscles are not well characterised with ageing. To further the understanding of age-related degeneration of the lumbar spine... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Morphological changes of the lumbar spine muscles are not well characterised with ageing. To further the understanding of age-related degeneration of the lumbar spine musculature, normative morphological changes that occur within the paravertebral muscles must first be established.
METHODS
A systematic review and meta-regressions were conducted adhering to PRISMA guidelines. Searches for published and unpublished data were completed in June 2019.
RESULTS
Searches returned 4781 articles. 34 articles were included in the quantitative analysis. Three-level meta-analyses showed age-related atrophy (r = -0.26; 95% CI: -0.33, -0.17) and fat infiltration (r = 0.39; 95% CI: 0.28, 0.50) in the lumbar paravertebral muscles. Degenerative changes were muscle-specific and men (r = -0.32; 95% CI: -0.61, 0.01) exhibited significantly greater muscle atrophy than women (r = -0.24; 95% CI: -0.47, 0.03). Imaging modality, specifically ultrasound, also influenced age-related muscle atrophy. Measurements taken across all lumbar levels revealed the greatest fat infiltration with ageing (r = 0.58, 95% CI: 0.35, 0.74). Moderators explained a large proportion of between-study variance in true effects for muscle atrophy (72.6%) and fat infiltration (79.8%) models.
CONCLUSIONS
Lumbar paravertebral muscles undergo age-related degeneration in healthy adults with muscle, lumbar level and sex-specific responses. Future studies should use high-resolution imaging modalities to quantify muscle atrophy and fat infiltration.
Topics: Female; Humans; Lumbar Vertebrae; Lumbosacral Region; Magnetic Resonance Imaging; Male; Muscles; Muscular Atrophy
PubMed: 32006635
DOI: 10.1016/j.exger.2020.110856 -
The Science of the Total Environment Mar 2020Aquatic biological communities have directly undergone human-induced changes. Altered hydrological and morphological processes in running waters have caused the... (Review)
Review
Aquatic biological communities have directly undergone human-induced changes. Altered hydrological and morphological processes in running waters have caused the degradation of main habitats for biotas and have disturbed ecosystem functionality. The latest advances in river restoration concerned the rise in far-reaching hydromorphological restoration actions that have been implemented below dams to reverse well-known negative impacts of anthropogenic pressures. Some authors emphasized the enhancement of sediment supply and habitat diversity using gravel augmentation or bank erosion to restore morphodynamics, and thus improve biodiversity. We explored the Web of Science database for empirical research papers that specifically addressed such hydromorphological river restoration actions. Articles were examined using a text-content analysis tool to determine the major concepts or ideas they deal with. It has also been proved as useful in defining interrelationships and degree of interdisciplinary. Results showed that a low number of published scientific articles exist about such projects, mainly condensed in the North hemisphere. Divergent ecological issues were highlighted by the word co-occurrence networks: (i) gravel augmentation was used to improve spawning habitats for fish of economic interest whereas (ii) erodible corridor was designed to safeguard natural riparian systems, approaching morphological goals of channel widening. Overall, ecological responses were consistent with those expected, leading however rather to functional shifts than richness increase. Gravel augmentation or bank erosion were not usually combined with in-channel structure management. However, this might be an option to consider since the biological communities seem to be sensitive during first restorations with such combination. This review demonstrates the value of word co-occurrence networks in exploring a high number of previous publications, keys for formulating guidance to manage gravel augmentation or bank erosion along ecological purposes.
PubMed: 31841838
DOI: 10.1016/j.scitotenv.2019.135743 -
Phytotherapy Research : PTR Mar 2020Flavonoids have been proposed as potential chemotherapeutic agents because they are toxic against cancer cells but not harmful to healthy cells. This systematic review...
Flavonoids have been proposed as potential chemotherapeutic agents because they are toxic against cancer cells but not harmful to healthy cells. This systematic review analyzed flavonoid effectiveness in human cancer chemotherapy. Overall, 22 phase II and 1 phase III clinical trials (PubMed, Scopus, and Web of Science) that used flavonoids as a single agent or combined with other therapeutics against hematopoietic/lymphoid or solid cancer published by January 2019 were selected for analysis. Flavopiridol was the most commonly used flavonoid (at a dose of 50-mg/m IV) for all tumor types. Aside from the relatively low rate of complete response (CR) or partial response (PR) with any administration protocol, flavonoids showed higher positive outcomes for hematopoietic and lymphoid tissues (140 patients with CR and 88 with PR among 615 patients in 11 trials) than for solid tumors (4 patients with CR and 21 with PR among 525 patients in 12 trials). However, because of the high variety in administration schedule, more studies are needed to further understand how flavonoids can promote positive outcomes for cancer patients.
Topics: Antineoplastic Agents; Clinical Trials as Topic; Flavonoids; Humans; Neoplasms; Piperidines; Polyphenols
PubMed: 31752046
DOI: 10.1002/ptr.6551 -
The American Journal of Surgical... Feb 2020Neoadjuvant chemoradiotherapy (CRT) is the standard of care for locally advanced rectal cancer. Morphologic changes such as fibrosis, inflammatory infiltrates, and the... (Meta-Analysis)
Meta-Analysis
Neoadjuvant chemoradiotherapy (CRT) is the standard of care for locally advanced rectal cancer. Morphologic changes such as fibrosis, inflammatory infiltrates, and the formation of extracellular mucin pools can be identified in the resection specimen after neoadjuvant CRT. The association of mucin pool formation with clinicopathologic variables and outcomes is unclear. The aim of this study was to meta-analyze all available evidence with regard to mucin pool formation and clinicopathologic outcomes following neoadjuvant CRT for rectal cancer. A comprehensive search for published studies analyzing outcomes between patients who formed mucin pools and patients who did not following neoadjuvant CRT for rectal cancer was performed. A random-effects model was used to combine the data. This study adhered to the recommendations of the MOOSE (Meta-analyses of Observational Studies in Epidemiology) guidelines. Data from 11 studies describing 1947 patients were included. Mucin pool formation was not associated with sex, T stage, N stage, tumor regression, pathologic complete response rate, lymphovascular invasion, perineural invasion, differentiation, margin status, local or distant recurrence, and disease-free or overall survival. Mucin pool formation is not associated with tumor response or downstaging; furthermore, on the basis of these data, it is not associated with local or systemic recurrence rate or survival.
Topics: Adenocarcinoma, Mucinous; Biomarkers, Tumor; Chemoradiotherapy, Adjuvant; Humans; Models, Statistical; Mucins; Neoadjuvant Therapy; Neoplasm Staging; Rectal Neoplasms; Survival Analysis; Treatment Outcome
PubMed: 31567193
DOI: 10.1097/PAS.0000000000001373 -
Journal of Clinical and Experimental... 2019New direct-acting antiviral agents (DAAs) approved for the treatment of patients infected by Hepatitis C virus (HCV) are well tolerated and increase sustained... (Review)
Review
BACKGROUND
New direct-acting antiviral agents (DAAs) approved for the treatment of patients infected by Hepatitis C virus (HCV) are well tolerated and increase sustained virological response (SVR) rate. We summarize current evidence on the efficacy and safety from comparative randomized controlled trials (RCTs) of DAAs.
METHODS
We systematically searched MEDLINE, Embase, Scopus, CENTRAL, and Lilacs as well as a list of reference literature. We included RCTs comparing DAAs with placebo or active control and reporting response rates and adverse events according to antiviral regimens. Risk ratios (RRs) were pooled as appropriate. We assessed the risk of bias of included studies and graded the quality of evidence according to the GRADE method.
RESULTS
We included 28 RCTs, enrolling more than 7000 patients. The quality of evidence was generally low. Twelve-week treatment with DAAs in naïve patients significantly increased SVR12 and SVR24 compared with placebo (RR 1.4, 95% CI 1.3-1.6; RR 1.5, 95% CI 1.4-1.6, respectively). This means that for every 1000 patients, 240 or 260 more patients experienced SVR12 or SVR24 if treated with any DAAs. We could not find RCTs assessing progression of liver disease or development of hepatocellular carcinoma. DAAs were not associated with higher incidence of serious adverse events or discontinuation due to adverse events.
CONCLUSIONS
This systematic review confirms that new DAAs are more effective in inducing SVR than placebo. Outside clinical trials, in real word, HCV cure with DAA regimens occurs in less than 90% of patients, so further comparative evaluations are needed to establish their long-term effects.
PubMed: 31516269
DOI: 10.1016/j.jceh.2018.07.004