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reviews in clinical medicine

Nelson Siukei Lam, Xinxin Long, Jonathan W Wong, Robert C Griffin, James C G Doery
Artemisinin (ART) and its derivatives are one of the most important classes of antimalarial agents, originally derived from a Chinese medicinal plant called Artemisia annua L. Beyond their outstanding antimalarial and antischistosomal activities, ART and its derivatives also possess both in-vitro and in-vivo activities against various types of cancer. Their anticancer effects range from initiation of apoptotic cell death to inhibition of cancer proliferation, metastasis and angiogenesis, and even modulation of the cell signal transduction pathway...
January 2019: Anti-cancer Drugs
Alessandro Gonçalves Campolina
Recently, professional and healthcare-related entities have launched frameworks designed to assess the value of cancer innovations in multistakeholder decision processes. Among the most visible entities that propose and implement value frameworks in oncology are the European Society of Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO), the Memorial Sloan Kettering Cancer Center (MSKCC) and the National Comprehensive Cancer Network (NCCN). However, these value frameworks have been criticized for conceptual inconsistencies, inability to include a greater variety of value criteria, and inadequate explanation of the uncertainty approach used in the modeling process...
December 10, 2018: Clinics
Jeanette M Bennett, Glenn Reeves, George E Billman, Joachim P Sturmberg
Siloed or singular system approach to disease management is common practice, developing out of traditional medical school education. Textbooks of medicine describe a huge number of discrete diseases, usually in a systematic fashion following headings like etiology, pathology, investigations, differential diagnoses, and management. This approach suggests that the body has a multitude of ways to respond to harmful incidences. However, physiology and systems biology provide evidence that there is a simple mechanism behind this phenotypical variability...
2018: Frontiers in Medicine
Nan Xiao, Hao Chen, Shi-Yong He, Chong-Xiang Xue, Hua Sui, Jing Chen, Jia-Lin Qu, Li-Na Liang, Lin Zhang
Objective. In China, the method of clearing heat and removing dampness medicine of Chinese traditional medicine has been widely used on gout. However, the clinical effects are various and not summarized systematically. Methods. In this study, a large number of randomized controlled clinical trials were reviewed and analyzed and the clinical efficacy and adverse reactions of traditional Chinese medicine with clearing heat and removing dampness effects for the treatment of gout were systematically evaluated. A comprehensive search of databases including pubMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, Wanfang Data, and SinoMed was performed...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Hong Li, Andrew Hung, Angela Wei Hong Yang
Chronic prostatitis (CP) is a chronic inflammation in the prostate with unsatisfactory management. Danggui Beimu Kushen Wan (DBKW) is a classic formula developed 1800 years ago for patients with difficult urination and it has been widely utilized for CP in modern days. However, scientific understanding of DBKW on CP has not been systematically reviewed. First, we searched the Encyclopedia of Traditional Chinese Medicine for the etiologies and pathogeneses of CP-like symptoms and DBKW and compared their similarities and differences from traditional Chinese medicine and conventional medicine perspectives...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Zhijun Liu, Pengyun Huang, Siukan Law, Haiyan Tian, Wingnang Leung, Chuanshan Xu
Cancer is still a severe threat to the health of people worldwide. Chemotherapy is one of main therapeutic approaches to combat cancer. However, chemotherapy only has a limited success with severe side effects, especially causing damage to normal tissues such as bone marrow, gastrointestine, heart, liver, renal, neuron, and auditory tissues, etc. The side-effects limit clinical outcome of chemotherapy and lower patients' quality of life, and even make many patients discontinue the chemotherapy. Thus, there is a need to explore effective adjuvant strategies to prevent and reduce the chemotherapy-induced side effects...
2018: Frontiers in Pharmacology
Mariele Gatto, Margherita Zen, Luca Iaccarino, Andrea Doria
The current treatment approach for systemic lupus erythematosus (SLE), as outlined in the recommendations by international medical associations including EULAR and the ACR, is mostly eminence-based rather than evidence-based. However, knowledge on SLE is growing quickly, and such new advances need to be translated into clinical practice. Questions remain regarding the choice and timing of drug administration and tapering until withdrawal, which both can affect the balance between the control of disease activity and damage to organs triggered by long-standing and/or disproportionate immunosuppression...
December 11, 2018: Nature Reviews. Rheumatology
Andrew M Blamire
Neurodegenerative disease is the umbrella term which refers to a range of clinical conditions causing degeneration of neurons within the central nervous system leading to loss of brain function and eventual death. The most prevalent of these is Alzheimer's disease (AD), which affects approximately 50 million people worldwide and is predicted to reach 75 million by 2030. Neurodegenerative diseases can only be fully diagnosed at post mortem by neuropathological assessment of the type and distribution of protein deposits which characterise each different condition, but there is a clear role for imaging technologies in aiding patient diagnoses in life...
October 2018: Progress in Nuclear Magnetic Resonance Spectroscopy
Inkyong Hur, Yong Kyu Lee, Kamyar Kalantar-Zadeh, Yoshitsugu Obi
BACKGROUND: Residual kidney function (RKF) is often expected to inevitably and rapidly decline among hemodialysis patients and, hence, has been inadvertently ignored in clinical practice. The importance of RKF has been revisited in some recent studies. Given that patients with end-stage renal disease now tend to initiate maintenance hemodialysis therapy with higher RKF levels, there seem to be important opportunities for incremental hemo-dialysis by individualizing the dose and frequency according to their RKF levels...
December 11, 2018: Cardiorenal Medicine
Dina Thompson, Kimberly Cox, James Loudon, Ivan Yeung, Woodrow Wells
PURPOSE: Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy. METHODS AND MATERIALS: Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017...
December 2018: Journal of Oncology Practice
Najmeh Ahangari, Saeid Kargozar, Majid Ghayour-Mobarhan, Francesco Baino, Alireza Pasdar, Amirhossein Sahebkar, Gordon A A Ferns, Hae-Won Kim, Masoud Mozafari
Curcumin is the principal polyphenolic compound present in turmeric with broad applications in tissue engineering and regenerative medicine. It has some important inherent properties with the potential to facilitate tissue healing, including anti-inflammatory, anti-oxidant, and antibacterial activities. Therefore, curcumin has been used for the treatment of various damaged tissues, especially wound injuries. There are different forms of curcumin, among which nano-formulations are of a great importance in regenerative medicine...
December 8, 2018: BioFactors
Ashwin Ramanathan, Lindsay Zhou, Faezeh Marzbanrad, Robert Roseby, Kenneth Tan, Ajay Kevat, Atul Malhotra
AIM: To explore, synthesise and discuss currently available digital stethoscopes (DS) and the evidence for their use in paediatric medicine. METHODS: Systematic review and narrative synthesis of digital stethoscope use in paediatrics following searches of OVID Medline, Embase, Scopus, PubMed and Google Scholar databases. RESULTS: Six digital stethoscope makes were identified to have been used in paediatric focused studies so far. A total of 25 studies of DS use in paediatrics were included...
December 7, 2018: Acta Paediatrica
(no author information available yet)
OBJECTIVE: To provide healthcare professionals with updated guidance in the use of novel preventive and acute treatments for migraine in adults. BACKGROUND: The principles of preventive and acute pharmacotherapy for patients with migraine have been outlined previously, but the emergence of new technologies and treatments, as well as new formulations of previously established treatments, has created a need for an updated guidance on the preventive and acute treatment of migraine...
December 10, 2018: Headache
Margarida Paiva Coelho, Esmeralda Martins, Laura Vilarinho
Primary mitochondrial disorders are highly variable in clinical presentation, biochemistry, and molecular etiology. Mitochondrial disorders can be caused by genetic defects in the mitochondrial, in nuclear genome, or in the interplay between the two genomes. Biochemical screening tests may be inconclusive or misleading since patients, with confirmed mitochondrial disorders specially in pediatric age, may exhibit normal routine biochemistry, muscle histology, or enzymatic analysis of the mitochondrial respiratory chain...
December 7, 2018: European Journal of Pediatrics
Filippo Migliorini, Markus Tingart, Marc Niewiera, Björn Rath, Jörg Eschweiler
PURPOSE: In the last couple of years, a significant amount of studies comparing the UKA and TKA for unicompartmental knee osteoarthritis have been published. However, there is a lack of recent meta-analysis comparing the two implants. Since the number of performed UKAs is currently increasing and the indications are obsolete, it becomes important to update current evidences and outcomes. With these premises, a meta-analysis of clinical trials comparing UKA versus TKA was conducted. METHODS: In October 2018, the following databases were accessed: Cochrane Systematic Reviews, Scopus, PubMed and Google Scholar...
December 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Hanxiao Xu, Ying Jiao, Shuang Qin, Weiheng Zhao, Qian Chu, Kongming Wu
Organoid technology bridges the gap between conventional two-dimensional cell line culture and in vivo models. The near-physiological technology can virtually recapitulates organ development and human diseases, such as infectious diseases, genetic abnormality and even cancers. In addition, organoids can more accurately predict drug responses, and serve as an excellent platform for drug development, including efficacy evaluation, toxicity testing and pharmacokinetics analysis. Furthermore, organoids can also be exploited to explore the possible optimized treatment strategies for each individual patient...
2018: Experimental Hematology & Oncology
Afreen Idris Shariff, Sohail Syed, Rebecca A Shelby, Jeremy Force, Jeffrey Melson Clarke, David D'Alessio, Leonor Corsino
Over the last decade, there has been a shift in the focus of cancer therapy from conventional cytotoxic drugs to therapies more specifically directed to cancer cells. These novel therapies include immunotherapy, targeted therapy and precision medicine, each developed in great part with a goal of limiting collateral destruction of normal tissues, while enhancing tumor destruction. Although this approach is sound in theory, even new, specific therapies have some undesirable, 'off target effects', in great part due to molecular pathways shared by neoplastic and normal cells...
February 1, 2019: Journal of Molecular Endocrinology
Iyo Koyanagi, Katherine G Akers, Pablo Vergara, Sakthivel Srinivasan, Takeshi Sakurai, Masanori Sakaguchi
In anticipation of the massive burden of neurodegenerative disease within super-aged societies, great efforts have been made to utilize neural stem and progenitor cells for regenerative medicine. The capacity of intrinsic neural stem and progenitor cells to regenerate damaged brain tissue remains unclear, due in part to the lack of knowledge about how these newly born neurons integrate into functional circuitry. As sizable integration of adult-born neurons naturally occurs in the dentate gyrus region of the hippocampus, clarifying the mechanisms of this process could provide insights for applying neural stem and progenitor cells in clinical settings...
January 2019: Neural Regeneration Research
David M Kent, Ewout Steyerberg, David van Klaveren
The use of evidence from clinical trials to support decisions for individual patients is a form of "reference class forecasting": implicit predictions for an individual are made on the basis of outcomes in a reference class of "similar" patients treated with alternative therapies. Evidence based medicine has generally emphasized the broad reference class of patients qualifying for a trial. Yet patients in a trial (and in clinical practice) differ from one another in many ways that can affect the outcome of interest and the potential for benefit...
December 10, 2018: BMJ: British Medical Journal
Paschalis Bizopoulos, Dimitris D G Koutsouris
The medical field is creating large amount of data that physicians are unable to comprehend and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. It is a representation learning method that consists of layers that transform the data non-linearly, thus revealing hierarchical relationships and structures...
December 10, 2018: IEEE Reviews in Biomedical Engineering
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