Journal of Medical Hypotheses and Ideas最新文献

Autism is a neurodevelopment disorder. Its aetiology and pathophysiology are not clearly known. However, mitochondria may play a significant role at least in some cases of autism. There is no therapeutic approach for autism. Moreover, there are only few Food and Drug Administration (FDA)-approved medications for autism. Therefore, providing novel therapeutic approaches are highly required. Oxidative stress is suggested as an important factor in the aetiology of autism. Already some interventions targeting oxidative stress in autism are suggested.

This article reviews evidence about the possible role of gold nanoparticles and lipoic acid (LA) as anti-inflammatory agents. It mentions some evidence about the possible role of oxidative stress. Then, the role of gold nanoparticles and LA for the management of autism is discussed.

According to the above-mentioned evidence, it is hypothesised that gold nanoparticles and LA may reduce neuro-inflammation in autism.

Controlled experimental studies are needed to test whether gold nanoparticles plus LA enhance antioxidative stress system leading to the improvement of autism clinical symptoms.

Child labour is an immense problem in Pakistan. As labour boys are put under persistent/severe physical stress, we hypothesised, that it may result in higher levels of cortisol and exhaust glycogen, fats and protein. Depletion of fats may result in lower body weight, and insufficient leptin concentrations could excite gonadotropic releasing hormone (GnRH) at normal time of puberty in working boys. Moreover, lower testosterone levels in working boys, due to delayed puberty, may result in suppression of somatotropic axis. Short/weak stature and failure of onset of puberty may cause poor performance, inferiority complex and psychological disorders. Therefore, the present study is designed to find out the timing of onset of puberty in working boys. The study will include 10–18 years of working boys as case and non-working boys of the same age group as control. Working boys will be labour boys, while the control group will not be involved in physical work. A questionnaire will be used to record socioeconomic status, major diseases, nutritional status, type and duration of work and family history of puberty, growth and obesity of subjects. Boys with familial history of pubertal delay, obesity, malnutrition, mental disorders, haematological diseases and severe/chronic diseases will be excluded. The intensity of physical working stress will be determined by a grading scale. The anthropometric data including height, weight, body mass index (BMI), bone age and tests of adiposity will be collected from subjects. The stages of pubertal onset will be determined by Tanner staging. Serum concentrations of hormones of growth, thyroid, adrenal, brain–gut and gonadal axis will be determined in non-working and working boys. Physical and hormonal tests of the working boys and the comparison with non-working boys are sufficient to test the idea.

Reconstruction of the extrahepatic bile duct following bile duct injury or defect is one of the most common challenges for hepatobiliary surgeons. There are currently a number of surgical strategies such as biliary-enteric anastomosis, end-to-end anastomosis and autologous tissue substitute. However, sphincter of Oddi dysfunction as well as biliary stricture may occur after surgical anastomosis. Also, insufficient tissue quantity remains a problem associated with the application of tissue substitute. Therefore, considerable attention has been attracted to explore a new replacement material of the bile duct for biliary reconstruction. The human umbilical cord (HUC) is abundant in resource and is convenient to collect, including two arteries and one vein, whose diameters are close to that of the common bile duct. In order to reduce immunogenicity (foreign-body reaction), cells and major histocompatibility complex (MHC) antigens can be removed from the HUC and the remaining tissue (extracellular matrix, ECM) can be used as a scaffold. The HUC provides a rich source of mesenchymal stem cells (MSCs). A current study has demonstrated that MSCs are able to differentiate into biliary epithelial cells in vivo and in vitro with low immunogenicity, which can be used as seed cells. The HUC might be a promising composite material of a scaffold (ECM) and seed cells (biliary epithelial cells), for bile duct replacement in situ without removal of sphincter of Oddi, or biliary stricture. In addition, the patients’ own umbilical cord without any foreign-body reaction can be directly banked for possible future use in bile duct reconstruction. Therefore, we hypothesise that the HUC may be a novel substitute for reconstruction of the extrahepatic bile duct.