Dm Disease-A-Month最新文献

{"title":"Pathogenesis and management of multiple sclerosis revisited","authors":"Abhi Shah ,&nbsp;Viraj Panchal ,&nbsp;Kashyap Patel ,&nbsp;Zainab Alimohamed ,&nbsp;Nirja Kaka MBBS ,&nbsp;Yashendra Sethi MBBS ,&nbsp;Neil Patel MBBS","doi":"10.1016/j.disamonth.2022.101497","DOIUrl":"10.1016/j.disamonth.2022.101497","url":null,"abstract":"<div><h3>Background</h3><p><span><span><span>Multiple sclerosis is an autoimmune chronic </span>inflammatory disease characterized by selective destruction of </span>myelin<span> in the CNS neurons (including optic nerve). It was first described in the 19</span></span>^th<span> century and remained elusive owing to the disease's<span> unique relapsing and remitting course. The widespread and debilitating prevalence of multiple sclerosis (MS) has prompted the development of various treatment modalities for its effective management.</span></span></p></div><div><h3>Methods and objectives</h3><p>A literature review was conducted using the electronic databases PubMed and Google Scholar. The main objective of the review was to compile the advances in pathogenesis, classifications, and evolving treatment modalities for MS.</p></div><div><h3>Results</h3><p><span>The understanding of the pathogenesis of MS and the potential drug targets for its precise treatment has evolved significantly over the past decade. The experimental developments are also motivating and present a big change coming up in the next 5 years. Numerous disease-modifying therapies (DMTs) have revolutionized the management of MS: </span>interferon<span><span> (IFN) preparations, monoclonal antibodies—natalizumab and ocrelizumab<span>, immunomodulatory agents—glatiramer acetate, sphingosine 1-phosphate receptor 1 (S1PR1) modulators (Siponimod) and teriflunomide<span>. The traditional parenteral drugs are now available as oral formulations improving patient acceptability. Repurposing various agents used for related diseases may reinforce the drug reserve to manage MS and are under trials. Although at a nascent phase, strategies to enhance re-myelination by stimulating oligodendrocytes are fascinating and hold promise for better outcomes </span></span></span>in patients with MS.</span></p></div><div><h3>Conclusions</h3><p>The recent past has seen staggering inclusions to the management of multiple sclerosis catalyzing a significant turnabout in our approach to diagnosis, treatment, and prognosis. Since the advent of DMTs various other oral and injectable agents have been approved. The advances in MS therapeutics and diagnostics have laid the ground for further research and development to enhance the quality of life of afflicted patients.</p></div>","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40568401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title Page","authors":"","doi":"10.1016/S0011-5029(23)00089-5","DOIUrl":"https://doi.org/10.1016/S0011-5029(23)00089-5","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49813661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C2: Editorial Board","authors":"","doi":"10.1016/S0011-5029(23)00088-3","DOIUrl":"https://doi.org/10.1016/S0011-5029(23)00088-3","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49813662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21st century","authors":"Donald E. Greydanus MD ,&nbsp;Berrin Ergun-Longmire MD ,&nbsp;Maria Demma Cabral MD ,&nbsp;Dilip R. Patel MD ,&nbsp;Cheryl A. Dickson MD","doi":"10.1016/j.disamonth.2022.101482","DOIUrl":"https://doi.org/10.1016/j.disamonth.2022.101482","url":null,"abstract":"<div><p>Behavioral aspects of organized sports activity for pediatric<span> athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs.</span></p><p>In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping<span><span> agents covered include anabolic steroids<span> (anabolic-androgenic steroids or AAS), androstenedione<span><span><span>, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), </span>clenbuterol, creatine, </span>gamma hydroxybutyrate (GHB), </span></span></span>amphetamines<span><span>, caffeine and ephedrine. Also considered are blood doping that includes </span>erythropoietin (EPO) and concepts of gene doping.</span></span></p><p><span><span>In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), </span>myelomeningocele, </span>cerebral palsy<span><span>, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with </span>visual impairment<span>, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized.</span></span></p><p>We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.</p></div>","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49813664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreword for psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21st Century","authors":"Jerrold B. Leikin","doi":"10.1016/j.disamonth.2022.101481","DOIUrl":"https://doi.org/10.1016/j.disamonth.2022.101481","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49855253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S0011-5029(23)00090-1","DOIUrl":"https://doi.org/10.1016/S0011-5029(23)00090-1","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49813660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Limitations and Recent Advances in the Management of Asthma","authors":"Vithi Hitendra Patel MBBS ,&nbsp;Srijani Thannir MBBS ,&nbsp;Maulik Dhanani MD ,&nbsp;Ivan Augustine MBBS ,&nbsp;S. L Sandeep MBBS ,&nbsp;Abdulrahim Mehadi MD ,&nbsp;Chaithanya Avanthika MBBS ,&nbsp;Sharan Jhaveri MBBS","doi":"10.1016/j.disamonth.2022.101483","DOIUrl":"10.1016/j.disamonth.2022.101483","url":null,"abstract":"<div><h3>Background</h3><p>Asthma is a significant worldwide health issue affecting kids and adults. Asthma management is mainly straightforward, but considering the associated co-morbidities, it is essential to diagnose the disease accurately. Steroid resistance<span><span> and dependence, along with inhaler abuse, are the other challenges in clinical practice. Despite being treated with the recommended guidelines, a good portion of the population has persistent symptoms. Emerging biological treatments can alter the global landscape of managing </span>severe asthma. With these new therapeutic possibilities, phenotype- and endotype-specific therapies can be used to individualize treatment plans.</span></p></div><div><h3>Methodology</h3><p><span>We searched Medline, Embase, Google Scholar, and PubMed until March 2022 for all types of literature. Medical Subject Heading (MeSH) terms such as “asthma,” “pathogenesis,” “diagnosis and classification,” “comorbidities,” “treatments,” “inhaler abuse &amp; corticosteroid resistance,” and “biologics” were used in the searches. To better understand the disease, we analyzed the literature on asthma regarding </span>pathophysiology, diagnostic criteria, endotypic and phenotypic classification, comorbidities, existing treatment guidelines, management challenges, and potential for biologics in uncontrolled cases.</p></div><div><h3>Results</h3><p>After exploring the data, our review article aims to highlight current limitations in the clinical management of asthma and the advances in treating asthma.</p></div><div><h3>Conclusion</h3><p>Clinical practice should consider an integrative approach to the care and prevention of asthma. We advocate for a large-scale cohort of observation studies and RCTs that further look into the underlying immunological mechanisms, the function of hereditary and environmental variables, and the novel molecular targets of asthma in light of the rising incidence and prevalence of the disease. Even with rising steroid resistance and dependence, the standard therapy will be the mainstream of asthma management. Biologics have promiscuous results and the potential for changing the treatment of uncontrolled asthma. Optimizing the standard therapy with biologics is needed to decrease asthma-related morbidity.</p></div>","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9634421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C2: Editorial Board","authors":"","doi":"10.1016/S0011-5029(23)00078-0","DOIUrl":"https://doi.org/10.1016/S0011-5029(23)00078-0","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49813638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic pulmonary fibrosis: Diagnosis, biomarkers and newer treatment protocols","authors":"Harshank Patel ,&nbsp;Jui Rakesh Shah ,&nbsp;Divya Rakeshkumar Patel ,&nbsp;Chaithanya Avanthika ,&nbsp;Sharan Jhaveri ,&nbsp;Kunj Gor","doi":"10.1016/j.disamonth.2022.101484","DOIUrl":"10.1016/j.disamonth.2022.101484","url":null,"abstract":"<div><p><span>Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung condition marked by lung scarring that progresses over time and with </span>usual interstitial pneumonia<span> histology (UIP). It is linked to a worsening cough, dyspnea, and a worse quality of life<span>. Around 3 million persons worldwide suffer from IPF, and the prevalence rises sharply with advancing age. The detection of the UIP pattern, generally using high-resolution CT; lung biopsy<span> may be necessary in certain individuals; the diagnostic approach also includes the elimination of other interstitial lung illnesses or overlapping problems. The UIP pattern is mostly bilateral, peripheral, and basal, with clusters of subpleural cystic airspaces and reticular alterations linked to traction bronchiectasis.</span></span></span></p><p>Although there are still many uncertainties about how to define susceptibility, it is believed that the molecular mechanisms causing IPF reflect an abnormal reparative response to repeated alveolar epithelial damage in an aging genetically sensitive individual. With the availability of two pharmacotherapeutic drugs<span>, pirfenidone<span><span> and nintedanib, that slow physiological advancement and potentially increase progression-free survival, significant progress has been made in our knowledge of the clinical </span>treatment of IPF. The goal of current research is to develop early biomarkers for IPF that may include circulating variables, demographic information, and imaging data.</span></span></p></div>","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9638752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreword: Pulmonary Issues in Primary Care","authors":"Jerrold B. Leikin MD","doi":"10.1016/j.disamonth.2022.101467","DOIUrl":"10.1016/j.disamonth.2022.101467","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10007491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}