Pub Date : 2024-05-01Epub Date: 2023-05-26DOI: 10.1177/21677026231170839
Olutosin Adesogan, Justin A Lavner, Sierra E Carter, Steven R H Beach
Centuries of systemic racism in the United States have led to Black Americans facing a disproportionate amount of life stressors. These stressors can have negative effects on mental and physical health, contributing to inequities throughout the lifespan. The current study used longitudinal data from 692 Black adults in the rural South to examine the ways in which neighborhood stress, financial strain, and interpersonal experiences of racial discrimination operate independently and in tandem to impact depressive symptoms and sleep problems over time. Findings provided strong support for univariate and additive stress effects and modest support for multiplicative stress effects. Results underscore how multiple stressors stemming from systemic racism can undermine health among Black Americans and highlight the need for further research on factors that promote well-being in the face of these stressors.
{"title":"Stress Accumulation, Depressive Symptoms, and Sleep Problems among Black Americans in the Rural South.","authors":"Olutosin Adesogan, Justin A Lavner, Sierra E Carter, Steven R H Beach","doi":"10.1177/21677026231170839","DOIUrl":"10.1177/21677026231170839","url":null,"abstract":"<p><p>Centuries of systemic racism in the United States have led to Black Americans facing a disproportionate amount of life stressors. These stressors can have negative effects on mental and physical health, contributing to inequities throughout the lifespan. The current study used longitudinal data from 692 Black adults in the rural South to examine the ways in which neighborhood stress, financial strain, and interpersonal experiences of racial discrimination operate independently and in tandem to impact depressive symptoms and sleep problems over time. Findings provided strong support for univariate and additive stress effects and modest support for multiplicative stress effects. Results underscore how multiple stressors stemming from systemic racism can undermine health among Black Americans and highlight the need for further research on factors that promote well-being in the face of these stressors.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"27 1","pages":"421-434"},"PeriodicalIF":4.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85940168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2022-05-05DOI: 10.1037/tra0001259
Erica P Messer, Emily A Eismann, Alonzo T Folger, Alex Grass, Julie Bemerer, Heather Bensman
Objective: To determine whether Parent-Child Interaction Therapy (PCIT) is as effective at reducing behavior problems for children with a history of trauma and for those who do not complete therapy.
Method: Retrospective chart review of patients between 2.5 and 6.5 years of age who participated in PCIT between January 1, 2012, and December 1, 2019, at a child advocacy center within a large Midwestern children's hospital was performed. Demographics, trauma history, and Eyberg Child Behavior Inventory (ECBI) and parenting confidence scores were collected. Changes in child behavior and parenting confidence over time were compared between patients with and without trauma exposure using separate generalized estimating equation models for those who did and did not complete PCIT.
Results: Of the 212 PCIT participants, 116 (54.72%) had a trauma history and 96 (45.28%) did not, and 98 (46.23%) completed PCIT and 114 (53.77%) did not. Patient demographics were fairly diverse and representative of the region. Patients with trauma exposure were significantly less likely to complete PCIT (38.79%) than patients without trauma exposure (55.21%). ECBI intensity scores significantly decreased over time among both patients who did and did not complete PCIT. The change in ECBI intensity scores over time did not differ between patients with and without trauma exposure regardless of whether or not they completed PCIT. Parenting confidence significantly improved over time regardless of trauma exposure or attrition.
Conclusions: Standard PCIT can be used effectively with children with trauma exposure and results in significant improvement even for those who do not complete therapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Comparative effectiveness of parent-child interaction therapy based on trauma exposure and attrition.","authors":"Erica P Messer, Emily A Eismann, Alonzo T Folger, Alex Grass, Julie Bemerer, Heather Bensman","doi":"10.1037/tra0001259","DOIUrl":"10.1037/tra0001259","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether Parent-Child Interaction Therapy (PCIT) is as effective at reducing behavior problems for children with a history of trauma and for those who do not complete therapy.</p><p><strong>Method: </strong>Retrospective chart review of patients between 2.5 and 6.5 years of age who participated in PCIT between January 1, 2012, and December 1, 2019, at a child advocacy center within a large Midwestern children's hospital was performed. Demographics, trauma history, and Eyberg Child Behavior Inventory (ECBI) and parenting confidence scores were collected. Changes in child behavior and parenting confidence over time were compared between patients with and without trauma exposure using separate generalized estimating equation models for those who did and did not complete PCIT.</p><p><strong>Results: </strong>Of the 212 PCIT participants, 116 (54.72%) had a trauma history and 96 (45.28%) did not, and 98 (46.23%) completed PCIT and 114 (53.77%) did not. Patient demographics were fairly diverse and representative of the region. Patients with trauma exposure were significantly less likely to complete PCIT (38.79%) than patients without trauma exposure (55.21%). ECBI intensity scores significantly decreased over time among both patients who did and did not complete PCIT. The change in ECBI intensity scores over time did not differ between patients with and without trauma exposure regardless of whether or not they completed PCIT. Parenting confidence significantly improved over time regardless of trauma exposure or attrition.</p><p><strong>Conclusions: </strong>Standard PCIT can be used effectively with children with trauma exposure and results in significant improvement even for those who do not complete therapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"20 1","pages":"S97-S105"},"PeriodicalIF":6.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85809164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orbital exenteration is a mutilating surgery which involves the removal of the entire contents of the bony orbit, including the globe, extraocular muscles and periorbital fat, and many times includes the eyelids. Since it leads to severe disfigurement, it is an infrequent procedure largely indicated in malignant conditions. The current study aims to report the clinicodemographic profile and treatment outcome of orbital exenteration patients done in a cancer care center in Northeast India. This is a hospital-based retrospective study between January 2017 and December 2021, including patients undergoing orbital exenteration. All patient and treatment-related data were retrieved from the record of hospital files. A total of 18 patients were included in the study. The mean age of the patients was 51 ± 18 years and male: female ratio was 1:1. Most patients had primary in orbit (55.6%). The most common histology was squamous cell carcinoma, (8/18, 44.4%), followed by basal cell carcinoma (two patients, 11.1%). After a median follow-up was 25 months (range 3-92), the median DFS of the study population was 31.4 months. The five-year overall survival of the patients was 54%. Orbital exenteration is an infrequent surgery due to the associated disfigurement and hence reserved for conditions where eye preservation is impossible. We tried to report the experience of orbital exenteration from a single cancer center for five years.
{"title":"Orbital Exenteration: Tumour Diversity and Survival-Report from a Cancer Centre of Northeast India.","authors":"Kaberi Kakati, Anupam Das, Jyotiman Nath, Kishore Das, Tashnin Rahman, Ashok Kumar Das, Raj Jyoti Das","doi":"10.1007/s12070-023-03950-8","DOIUrl":"10.1007/s12070-023-03950-8","url":null,"abstract":"<p><p>Orbital exenteration is a mutilating surgery which involves the removal of the entire contents of the bony orbit, including the globe, extraocular muscles and periorbital fat, and many times includes the eyelids. Since it leads to severe disfigurement, it is an infrequent procedure largely indicated in malignant conditions. The current study aims to report the clinicodemographic profile and treatment outcome of orbital exenteration patients done in a cancer care center in Northeast India. This is a hospital-based retrospective study between January 2017 and December 2021, including patients undergoing orbital exenteration. All patient and treatment-related data were retrieved from the record of hospital files. A total of 18 patients were included in the study. The mean age of the patients was 51 ± 18 years and male: female ratio was 1:1. Most patients had primary in orbit (55.6%). The most common histology was squamous cell carcinoma, (8/18, 44.4%), followed by basal cell carcinoma (two patients, 11.1%). After a median follow-up was 25 months (range 3-92), the median DFS of the study population was 31.4 months. The five-year overall survival of the patients was 54%. Orbital exenteration is an infrequent surgery due to the associated disfigurement and hence reserved for conditions where eye preservation is impossible. We tried to report the experience of orbital exenteration from a single cancer center for five years.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"44 1","pages":"3268-3276"},"PeriodicalIF":0.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10645857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86312479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-06Print Date: 2022-10-01DOI: 10.1183/13993003.02395-2021
Evelien R van Meel, Sara M Mensink-Bout, Herman T den Dekker, Tarunveer S Ahluwalia, Isabella Annesi-Maesano, Syed Hasan Arshad, Nour Baïz, Henrique Barros, Andrea von Berg, Hans Bisgaard, Klaus Bønnelykke, Christian J Carlsson, Maribel Casas, Leda Chatzi, Cecile Chevrier, Geertje Dalmeijer, Carol Dezateux, Karel Duchen, Merete Eggesbø, Cornelis van der Ent, Maria Fantini, Claudia Flexeder, Urs Frey, Fransesco Forastiere, Ulrike Gehring, Davide Gori, Raquel Granell, Lucy J Griffiths, Hazel Inskip, Joanna Jerzynska, Anne M Karvonen, Thomas Keil, Cecily Kelleher, Manolis Kogevinas, Gudrun Koppen, Claudia E Kuehni, Nathalie Lambrechts, Susanne Lau, Irina Lehmann, Johnny Ludvigsson, Maria Christine Magnus, Erik Mélen, John Mehegan, Monique Mommers, Anne-Marie Nybo Andersen, Wenche Nystad, Eva S L Pedersen, Juha Pekkanen, Ville Peltola, Katharine C Pike, Angela Pinot de Moira, Costanza Pizzi, Kinga Polanska, Maja Popovic, Daniela Porta, Graham Roberts, Ana Cristina Santos, Erica S Schultz, Marie Standl, Jordi Sunyer, Carel Thijs, Laura Toivonen, Eleonora Uphoff, Jakob Usemann, Marina Vafeidi, John Wright, Johan C de Jongste, Vincent W V Jaddoe, Liesbeth Duijts
Background: Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age.
Methods: We used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75%) and asthma at a median (range) age of 7 (4-15) years.
Results: Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75% (z-score range: -0.09 (95% CI -0.14- -0.04) to -0.30 (95% CI -0.36- -0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98-2.22) to 6.30 (95% CI 5.64-7.04) and 1.25 (95% CI 1.18-1.32) to 1.55 (95% CI 1.47-1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma.
Conclusions: Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections.
背景:早年呼吸道感染可能会影响慢性阻塞性呼吸道疾病,但目前还缺乏针对普通人群的确凿研究。我们的目的是研究早期呼吸道感染的儿童是否会增加学龄期肺功能下降和哮喘的风险:我们利用主要来自欧盟儿童队列网络的 150 090 名儿童的个人参与者数据,研究了 6 个月至 5 岁期间上呼吸道和下呼吸道感染与 1 秒用力呼气容积 (FEV1)、用力肺活量 (FVC)、FEV1/FVC、75% FVC 时的用力呼气流量 (FEF75%) 以及 7(4-15)岁中位数哮喘之间的关系:结果发现:早年患下呼吸道感染而非上呼吸道感染的儿童,其学龄期FEV1、FEV1/FVC和FEF75%均较低(Z值范围:-0.09(95% CI -0.14--0.04)至-0.30(95% CI -0.36--0.24))。与患有上呼吸道感染的儿童相比,早年患有下呼吸道感染的儿童在学龄期患哮喘的风险更高(OR 范围分别为:2.10(95% CI 1.98-2.22)至 6.30(95% CI 5.64-7.04)和 1.25(95% CI 1.18-1.32)至 1.55(95% CI 1.47-1.65))。对之前的呼吸道感染进行调整后,影响的强度略有下降。观察到的相关性在有和没有早期喘息(作为早期哮喘的替代指标)的人群中相似:我们的研究结果表明,早年呼吸道感染会影响日后慢性阻塞性呼吸道疾病的发展,其中下呼吸道感染的影响最大。
{"title":"Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children.","authors":"Evelien R van Meel, Sara M Mensink-Bout, Herman T den Dekker, Tarunveer S Ahluwalia, Isabella Annesi-Maesano, Syed Hasan Arshad, Nour Baïz, Henrique Barros, Andrea von Berg, Hans Bisgaard, Klaus Bønnelykke, Christian J Carlsson, Maribel Casas, Leda Chatzi, Cecile Chevrier, Geertje Dalmeijer, Carol Dezateux, Karel Duchen, Merete Eggesbø, Cornelis van der Ent, Maria Fantini, Claudia Flexeder, Urs Frey, Fransesco Forastiere, Ulrike Gehring, Davide Gori, Raquel Granell, Lucy J Griffiths, Hazel Inskip, Joanna Jerzynska, Anne M Karvonen, Thomas Keil, Cecily Kelleher, Manolis Kogevinas, Gudrun Koppen, Claudia E Kuehni, Nathalie Lambrechts, Susanne Lau, Irina Lehmann, Johnny Ludvigsson, Maria Christine Magnus, Erik Mélen, John Mehegan, Monique Mommers, Anne-Marie Nybo Andersen, Wenche Nystad, Eva S L Pedersen, Juha Pekkanen, Ville Peltola, Katharine C Pike, Angela Pinot de Moira, Costanza Pizzi, Kinga Polanska, Maja Popovic, Daniela Porta, Graham Roberts, Ana Cristina Santos, Erica S Schultz, Marie Standl, Jordi Sunyer, Carel Thijs, Laura Toivonen, Eleonora Uphoff, Jakob Usemann, Marina Vafeidi, John Wright, Johan C de Jongste, Vincent W V Jaddoe, Liesbeth Duijts","doi":"10.1183/13993003.02395-2021","DOIUrl":"10.1183/13993003.02395-2021","url":null,"abstract":"<p><strong>Background: </strong>Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age.</p><p><strong>Methods: </strong>We used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV<sub>1</sub>), forced vital capacity (FVC), FEV<sub>1</sub>/FVC, forced expiratory flow at 75% of FVC (FEF<sub>75%</sub>) and asthma at a median (range) age of 7 (4-15) years.</p><p><strong>Results: </strong>Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV<sub>1</sub>, FEV<sub>1</sub>/FVC and FEF<sub>75%</sub> (z-score range: -0.09 (95% CI -0.14- -0.04) to -0.30 (95% CI -0.36- -0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98-2.22) to 6.30 (95% CI 5.64-7.04) and 1.25 (95% CI 1.18-1.32) to 1.55 (95% CI 1.47-1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma.</p><p><strong>Conclusions: </strong>Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9535116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86607694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-16DOI: 10.33588/rn.7406.2021383
P E Balcarce
Introduction: The finding of an eyelid ptosis in a manuscript of the xiii century raises the differential diagnosis of injury to the third cranial nerve. This nerve was not differentiated from the other oculomotors until the xvi century and only in the xix century a clinicopathological correlation was established for its paralysis.
Aim: Describe the characteristics and differential diagnoses of an eyelid ptosis illustrated in the Book of Divine Works (1173) by Hildegard of Bingen.
Development: In the mentioned work the nun Richardis of Stade is portrayed with her left eyelid drooping. Two conspicuous signs are described, ptosis and corresponding raising of the eyebrow. The deviation of the eye downward and outward is inferred from the shape that adopts the eyelid by the position of the eye and the curvature of the cornea. The picture is consistent with an isolated paralysis of the oculomotor nerve. The causes of ptosis are discussed: aponeurotic due to levator palpebrae dehiscence; myogenic, congenital and acquired; of the neuromuscular junction, and neuropathic, the latter being the most probable in this case and of a compressive mechanism. The nun's unexpected natural death suggests a ruptured brain aneurysm.
Conclusions: Richardis of Stade's portrait shows an oculomotor paralysis centuries before its anatomy, function, and clinicopathological expression were known. Credit for this original description must go to Hildegard, whose medical vocation has long been recognized.
简介在十三世纪的一份手稿中发现的眼睑下垂引起了第三颅神经损伤的鉴别诊断。该神经直到十六世纪才与其他眼球运动神经区分开来,直到十九世纪才确定了其瘫痪的临床病理相关性。目的:描述宾根的希尔德加德在《神作之书》(1173 年)中描绘的眼睑下垂的特征和鉴别诊断:在上述作品中,修女 Richardis of Stade 的左眼睑下垂。作品中描述了两个明显的征兆:眼睑下垂和相应的眉毛上扬。根据眼睑的形状、眼睛的位置和角膜的弧度,可以推断出眼睛向下和向外的偏差。这种情况与孤立的眼球运动神经麻痹一致。对上睑下垂的病因进行了讨论:上睑提肌开裂导致的肌腱性下垂、先天性和后天性肌源性下垂、神经肌肉接头处的下垂以及神经性下垂,后者在本病例中的可能性最大,而且是一种压迫性机制。修女的意外自然死亡表明是脑动脉瘤破裂:结论:斯泰德的理查德斯的肖像展示的是一种眼球运动麻痹,比人们了解其解剖、功能和临床病理表现早了几个世纪。希尔德加德对这一原始描述功不可没,她的医学使命早已得到认可。
{"title":"[Study of an ocular ptosis in a 13th century illuminated manuscript].","authors":"P E Balcarce","doi":"10.33588/rn.7406.2021383","DOIUrl":"10.33588/rn.7406.2021383","url":null,"abstract":"<p><strong>Introduction: </strong>The finding of an eyelid ptosis in a manuscript of the xiii century raises the differential diagnosis of injury to the third cranial nerve. This nerve was not differentiated from the other oculomotors until the xvi century and only in the xix century a clinicopathological correlation was established for its paralysis.</p><p><strong>Aim: </strong>Describe the characteristics and differential diagnoses of an eyelid ptosis illustrated in the Book of Divine Works (1173) by Hildegard of Bingen.</p><p><strong>Development: </strong>In the mentioned work the nun Richardis of Stade is portrayed with her left eyelid drooping. Two conspicuous signs are described, ptosis and corresponding raising of the eyebrow. The deviation of the eye downward and outward is inferred from the shape that adopts the eyelid by the position of the eye and the curvature of the cornea. The picture is consistent with an isolated paralysis of the oculomotor nerve. The causes of ptosis are discussed: aponeurotic due to levator palpebrae dehiscence; myogenic, congenital and acquired; of the neuromuscular junction, and neuropathic, the latter being the most probable in this case and of a compressive mechanism. The nun's unexpected natural death suggests a ruptured brain aneurysm.</p><p><strong>Conclusions: </strong>Richardis of Stade's portrait shows an oculomotor paralysis centuries before its anatomy, function, and clinicopathological expression were known. Credit for this original description must go to Hildegard, whose medical vocation has long been recognized.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"42 1","pages":"202-206"},"PeriodicalIF":0.8,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86277470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-23DOI: 10.1002/14651858.CD004477.pub3
Sharon R Lewis, Michael W Pritchard, Carmel M Thomas, Andrew F Smith
<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by direct or indirect injury to the lungs. Despite improvements in clinical management (for example, lung protection strategies), mortality in this patient group is at approximately 40%. This is an update of a previous version of this review, last published in 2004.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of pharmacological agents in adults with ARDS on mortality, mechanical ventilation, and fitness to return to work at 12 months.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and CINAHL on 10 December 2018. We searched clinical trials registers and grey literature, and handsearched reference lists of included studies and related reviews.</p><p><strong>Selection criteria: </strong>We included randomized controlled trials (RCTs) comparing pharmacological agents with control (placebo or standard therapy) to treat adults with established ARDS. We excluded trials of nitric oxide, inhaled prostacyclins, partial liquid ventilation, neuromuscular blocking agents, fluid and nutritional interventions and medical oxygen. We excluded studies published earlier than 2000, because of changes to lung protection strategies for people with ARDS since this date.</p><p><strong>Data collection and analysis: </strong>Two review authors independently assessed studies for inclusion, extracted data, and assessed risks of bias. We assessed the certainty of evidence with GRADE.</p><p><strong>Main results: </strong>We included 48 RCTs with 6299 participants who had ARDS; two included only participants with mild ARDS (also called acute lung injury). Most studies included causes of ARDS that were both direct and indirect injuries. We noted differences between studies, for example the time of administration or the size of dose, and because of unclear reporting we were uncertain whether all studies had used equivalent lung protection strategies.We included five types of agents as the primary comparisons in the review: corticosteroids, surfactants, N-acetylcysteine, statins, and beta-agonists. We included 15 additional agents (sivelestat, mesenchymal stem cells, ulinastatin, anisodimine, angiotensin-converting enzyme (ACE) inhibitor, recombinant human ACE2 (palifermin), AP301, granulocyte-macrophage colony stimulating factor (GM-CSF), levosimendan, prostacyclins, lisofylline, ketaconazole, nitroglycerins, L-2-oxothiazolidine-4-carboxylic acid (OTZ), and penehyclidine hydrochloride).We used GRADE to downgrade outcomes for imprecision (because of few studies and few participants), for study limitations (e.g. high risks of bias) and for inconsistency (e.g. differences between study data).Corticosteroids versus placebo or standard therapyCorticosteroids may reduce all-cause mortality within three months by 86 per 1000 patients (with as many as 161 fewer to 19 more deaths); however, the 95% confidence interval (CI) i
背景:急性呼吸窘迫综合征(ARDS)是由肺部直接或间接损伤引起的危及生命的疾病。尽管临床管理有所改善(例如肺保护策略),但该患者组的死亡率约为40%。这是对本综述的上一版本的更新,上次发表于2004年。目的评价药物治疗成人急性呼吸窘迫综合征(ARDS)患者12个月时死亡率、机械通气和恢复工作能力的有效性。检索方法我们于2018年12月10日检索了CENTRAL, MEDLINE, Embase和CINAHL。我们检索了临床试验注册和灰色文献,并手工检索了纳入研究和相关综述的参考文献列表。选择标准我们纳入了比较药物与对照组(安慰剂或标准疗法)治疗已确诊的成人ARDS的随机对照试验(rct)。我们排除了一氧化氮、吸入性前列环素、部分液体通气、神经肌肉阻断剂、液体和营养干预以及医用氧的试验。我们排除了2000年以前发表的研究,因为自2000年以来,ARDS患者的肺保护策略发生了变化。数据收集和分析两篇综述作者独立评估了研究的纳入、提取数据和评估偏倚风险。我们用GRADE评估证据的确定性。我们纳入48项随机对照试验,6299名ARDS患者;其中两项仅包括轻度ARDS(也称为急性肺损伤)的参与者。大多数研究包括ARDS的直接和间接伤害原因。我们注意到研究之间的差异,例如给药时间或剂量大小,并且由于报告不明确,我们不确定是否所有研究都使用了相同的肺保护策略。我们在综述中纳入了五种类型的药物作为主要比较:皮质类固醇、表面活性剂、n -乙酰半胱氨酸、他汀类药物和β受体激动剂。我们纳入了另外15种药物(西维司他、间充质干细胞、乌司他丁、山莨菪碱、血管紧张素转换酶(ACE)抑制剂、重组人ACE2 (palifermin)、AP301、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、左西孟旦、前列环素、异油碱、酮康唑、硝化甘油、l -2-氧噻唑烷-4-羧酸(OTZ)和盐酸戊乙奎醚)。我们使用GRADE来降低结果的不精确性(因为研究和参与者很少)、研究局限性(例如高偏倚风险)和不一致性(例如研究数据之间的差异)。与安慰剂或标准治疗相比,皮质类固醇可使3个月内的全因死亡率每1000名患者降低86例(死亡人数减少161例至19例);然而,95%置信区间(CI)包括死亡增加和减少的可能性(风险比(RR) 0.77, 95% CI 0.57 ~ 1.05;6项研究,574名参与者;确定性的证据)。由于证据的确定性非常低,我们不确定皮质类固醇对晚期全因死亡率(超过3个月)的影响是否很小或没有影响(RR 0.99, 95% CI 0.64至1.52;1项研究,180名受试者),或机械通气持续时间(平均差异(MD) -4.30, 95% CI -9.72至1.12;3项研究,277名参与者)。我们发现皮质类固醇可改善无呼吸机天数(VFD) (MD 4.09, 95% CI 1.74至6.44;4项研究,494名参与者;确定性的证据)。没有研究报告不良事件导致研究药物停药,或12个月后恢复工作(FTR)。表面活性剂与安慰剂或标准治疗相比,我们不确定表面活性剂对早期死亡率的影响是很小还是没有差异(RR 1.08, 95% CI 0.91至1.29;9项研究,1338名受试者),或者是否降低晚期全因死亡率(RR 1.28, 95% CI 1.01 - 1.61;1项研究,418名参与者)。同样,我们不确定表面活性剂是否会缩短机械通气时间(MD -2.50, 95% CI -4.95至-0.05;1项研究,16名参与者),对VFD的影响很小或没有影响(MD -0.39, 95% CI -2.49至1.72;2项研究,344名受试者),或不良事件导致停止研究用药(RR 0.50, 95% CI 0.17 ~ 1.44;2项研究,88名参与者)。我们不确定这些影响,因为我们评估它们的确定性非常低。没有研究报告FTR。n -乙酰半胱氨酸与安慰剂我们不确定n -乙酰半胱氨酸对早期死亡率的影响是否很小或没有影响,因为我们将其评估为非常低确定性的证据(RR 0.64, 95% CI 0.32至1.30;1项研究,36名参与者)。没有研究报告晚期全因死亡率、机械通气持续时间、VFD、导致研究药物停药的不良事件或FTR。他汀类药物与安慰剂相比,他汀类药物对早期死亡率的影响可能很小或没有差异(RR 0.99, 95% CI 0.78 - 1)。 26;3 项研究,1344 名参与者;中度确定性证据)或 VFD(MD 0.40,95% CI -0.71 至 1.52;3 项研究,1342 名参与者;中度确定性证据)。他汀类药物对机械通气持续时间的影响可能很小或没有影响(MD 2.70,95% CI -3.55至8.95;1项研究,60名参与者;低度确定性证据)。我们无法纳入一项研究中导致停药的不良事件数据,因为其报告不明确。β-受体激动剂与安慰剂对照β-受体阻滞剂可能会略微增加早期死亡率,每 1000 例患者中有 40 例死亡(多达 119 例增加或 25 例减少);然而,95% CI 包括死亡率增加或减少的可能性(RR 1.14,95% CI 0.91 至 1.42;3 项研究,646 例参与者;中度确定性证据)。由于证据的确定性很低,我们无法确定β-受体激动剂是否会增加VFD(MD -2.20,95% CI -3.68至-0.71;3项研究,646名参与者),或对导致研究药物停用的不良事件影响很小或没有影响(一项研究报道组间差异很小或没有差异,一项研究报道β-受体激动剂组发生的事件较多)。没有研究报告了后期全因死亡率、机械通气持续时间或 FTR:我们没有发现足够的证据来确定皮质类固醇、表面活性物质、N-乙酰半胱氨酸、他汀类药物或β-受体激动剂是否能有效降低ARDS患者的死亡率、缩短机械通气时间或增加无呼吸机天数。三项有待分类的研究可能会改变本综述的结论。由于 ARDS 潜在的长期后果对幸存者非常重要,因此未来的研究应纳入更长时间的随访,以衡量对生活质量的影响。
{"title":"Pharmacological agents for adults with acute respiratory distress syndrome.","authors":"Sharon R Lewis, Michael W Pritchard, Carmel M Thomas, Andrew F Smith","doi":"10.1002/14651858.CD004477.pub3","DOIUrl":"10.1002/14651858.CD004477.pub3","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by direct or indirect injury to the lungs. Despite improvements in clinical management (for example, lung protection strategies), mortality in this patient group is at approximately 40%. This is an update of a previous version of this review, last published in 2004.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of pharmacological agents in adults with ARDS on mortality, mechanical ventilation, and fitness to return to work at 12 months.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and CINAHL on 10 December 2018. We searched clinical trials registers and grey literature, and handsearched reference lists of included studies and related reviews.</p><p><strong>Selection criteria: </strong>We included randomized controlled trials (RCTs) comparing pharmacological agents with control (placebo or standard therapy) to treat adults with established ARDS. We excluded trials of nitric oxide, inhaled prostacyclins, partial liquid ventilation, neuromuscular blocking agents, fluid and nutritional interventions and medical oxygen. We excluded studies published earlier than 2000, because of changes to lung protection strategies for people with ARDS since this date.</p><p><strong>Data collection and analysis: </strong>Two review authors independently assessed studies for inclusion, extracted data, and assessed risks of bias. We assessed the certainty of evidence with GRADE.</p><p><strong>Main results: </strong>We included 48 RCTs with 6299 participants who had ARDS; two included only participants with mild ARDS (also called acute lung injury). Most studies included causes of ARDS that were both direct and indirect injuries. We noted differences between studies, for example the time of administration or the size of dose, and because of unclear reporting we were uncertain whether all studies had used equivalent lung protection strategies.We included five types of agents as the primary comparisons in the review: corticosteroids, surfactants, N-acetylcysteine, statins, and beta-agonists. We included 15 additional agents (sivelestat, mesenchymal stem cells, ulinastatin, anisodimine, angiotensin-converting enzyme (ACE) inhibitor, recombinant human ACE2 (palifermin), AP301, granulocyte-macrophage colony stimulating factor (GM-CSF), levosimendan, prostacyclins, lisofylline, ketaconazole, nitroglycerins, L-2-oxothiazolidine-4-carboxylic acid (OTZ), and penehyclidine hydrochloride).We used GRADE to downgrade outcomes for imprecision (because of few studies and few participants), for study limitations (e.g. high risks of bias) and for inconsistency (e.g. differences between study data).Corticosteroids versus placebo or standard therapyCorticosteroids may reduce all-cause mortality within three months by 86 per 1000 patients (with as many as 161 fewer to 19 more deaths); however, the 95% confidence interval (CI) i","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"58 1","pages":"CD004477"},"PeriodicalIF":8.8,"publicationDate":"2019-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86597802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-01DOI: 10.1213/XAA.0000000000000459
Tiffany M N Otero, Samuel R Barber, D Dante Yeh, Sadeq A Quraishi
The authors report a case of necrotizing Sweet syndrome in a 24-year-old transsexual male who presented with recurrent myonecrosis of the neck/upper chest. On index admission, computer tomography revealed gas and fat stranding of the sternocleidomastoid and pectoralis major muscle-findings suggestive of a necrotizing soft tissue infection. Despite debridement procedures and intravenous antibiotic therapy, myonecrosis of the affected areas persisted. Evaluation of tissue samples by dermatopathology revealed neutrophilic infiltration extending into the dermis and muscle necrosis, findings consistent with necrotizing Sweet syndrome. The initiation of IV corticosteroids, the gold-standard treatment for necrotizing Sweet syndrome, lead to significant clinical improvement. When soft tissue infections do not respond to debridement and broad-spectrum antimicrobial coverage, perioperative care providers should consider necrotizing Sweet syndrome as an underlying cause. By facilitating the early diagnosis and appropriate management of unique conditions such as necrotizing Sweet syndrome, anesthesiologists can not only play a more visible role as leaders in the emerging perioperative surgical home model, but they may also prevent significant patient morbidity and reduce unnecessary utilization of health care resources.
{"title":"Necrotizing Soft Tissue Infection or Sweet Syndrome: Surgery Versus No Surgery?: A Case Report.","authors":"Tiffany M N Otero, Samuel R Barber, D Dante Yeh, Sadeq A Quraishi","doi":"10.1213/XAA.0000000000000459","DOIUrl":"10.1213/XAA.0000000000000459","url":null,"abstract":"<p><p>The authors report a case of necrotizing Sweet syndrome in a 24-year-old transsexual male who presented with recurrent myonecrosis of the neck/upper chest. On index admission, computer tomography revealed gas and fat stranding of the sternocleidomastoid and pectoralis major muscle-findings suggestive of a necrotizing soft tissue infection. Despite debridement procedures and intravenous antibiotic therapy, myonecrosis of the affected areas persisted. Evaluation of tissue samples by dermatopathology revealed neutrophilic infiltration extending into the dermis and muscle necrosis, findings consistent with necrotizing Sweet syndrome. The initiation of IV corticosteroids, the gold-standard treatment for necrotizing Sweet syndrome, lead to significant clinical improvement. When soft tissue infections do not respond to debridement and broad-spectrum antimicrobial coverage, perioperative care providers should consider necrotizing Sweet syndrome as an underlying cause. By facilitating the early diagnosis and appropriate management of unique conditions such as necrotizing Sweet syndrome, anesthesiologists can not only play a more visible role as leaders in the emerging perioperative surgical home model, but they may also prevent significant patient morbidity and reduce unnecessary utilization of health care resources.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"60 1","pages":"182-185"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1213/XAA.0000000000000459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86617118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the last 50 years, we argue that incentives for academic scientists have become increasingly perverse in terms of competition for research funding, development of quantitative metrics to measure performance, and a changing business model for higher education itself. Furthermore, decreased discretionary funding at the federal and state level is creating a hypercompetitive environment between government agencies (e.g., EPA, NIH, CDC), for scientists in these agencies, and for academics seeking funding from all sources-the combination of perverse incentives and decreased funding increases pressures that can lead to unethical behavior. If a critical mass of scientists become untrustworthy, a tipping point is possible in which the scientific enterprise itself becomes inherently corrupt and public trust is lost, risking a new dark age with devastating consequences to humanity. Academia and federal agencies should better support science as a public good, and incentivize altruistic and ethical outcomes, while de-emphasizing output.
{"title":"Academic Research in the 21st Century: Maintaining Scientific Integrity in a Climate of Perverse Incentives and Hypercompetition.","authors":"Marc A Edwards, Siddhartha Roy","doi":"10.1089/ees.2016.0223","DOIUrl":"10.1089/ees.2016.0223","url":null,"abstract":"<p><p>Over the last 50 years, we argue that incentives for academic scientists have become increasingly perverse in terms of competition for research funding, development of quantitative metrics to measure performance, and a changing business model for higher education itself. Furthermore, decreased discretionary funding at the federal and state level is creating a hypercompetitive environment between government agencies (e.g., EPA, NIH, CDC), for scientists in these agencies, and for academics seeking funding from all sources-the combination of perverse incentives and decreased funding increases pressures that can lead to unethical behavior. If a critical mass of scientists become untrustworthy, a tipping point is possible in which the scientific enterprise itself becomes inherently corrupt and public trust is lost, risking a new dark age with devastating consequences to humanity. Academia and federal agencies should better support science as a public good, and incentivize altruistic and ethical outcomes, while de-emphasizing output.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"44 1","pages":"51-61"},"PeriodicalIF":1.8,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86311554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-08-01DOI: 10.1007/s12016-016-8529-8
Andrea Sukhov, Iannis E Adamopoulos, Emanual Maverakis
Cutaneous psoriasis (e.g., psoriasis vulgaris (PsV)) and psoriatic arthritis (PsA) are complex heterogeneous diseases thought to have similar pathophysiology. The soluble and cellular mediators of these closely related diseases are being elucidated through genetic approaches such as genome-wide association studies (GWAS), as well as animal and molecular models. Novel therapeutics targeting these mediators (IL-12, IL-23, IL-17, IL-17 receptor, TNF) are effective in treating both the skin and joint manifestations of psoriasis, reaffirming the shared pathophysiology of PsV and PsA. However, the molecular and cellular interactions between skin and joint disease have not been well characterized. Clearly, PsV and PsA are highly variable in terms of their clinical manifestations, and this heterogeneity can partially be explained by differences in HLA-associations (HLA-Cw*0602 versus HLA-B*27, for example). In addition, there are numerous other genetic susceptibility loci (LCE3, CARD14, NOS2, NFKBIA, PSMA6, ERAP1, TRAF3IP2, IL12RB2, IL23R, IL12B, TNIP1, TNFAIP3, TYK2) and geoepidemiologic factors that contribute to the wide variability seen in psoriasis. Herein, we review the complex interplay between the genetic, cellular, ethnic, and geographic mediators of psoriasis, focusing on the shared mechanisms of PsV and PsA.
{"title":"Interactions of the Immune System with Skin and Bone Tissue in Psoriatic Arthritis: A Comprehensive Review.","authors":"Andrea Sukhov, Iannis E Adamopoulos, Emanual Maverakis","doi":"10.1007/s12016-016-8529-8","DOIUrl":"10.1007/s12016-016-8529-8","url":null,"abstract":"<p><p>Cutaneous psoriasis (e.g., psoriasis vulgaris (PsV)) and psoriatic arthritis (PsA) are complex heterogeneous diseases thought to have similar pathophysiology. The soluble and cellular mediators of these closely related diseases are being elucidated through genetic approaches such as genome-wide association studies (GWAS), as well as animal and molecular models. Novel therapeutics targeting these mediators (IL-12, IL-23, IL-17, IL-17 receptor, TNF) are effective in treating both the skin and joint manifestations of psoriasis, reaffirming the shared pathophysiology of PsV and PsA. However, the molecular and cellular interactions between skin and joint disease have not been well characterized. Clearly, PsV and PsA are highly variable in terms of their clinical manifestations, and this heterogeneity can partially be explained by differences in HLA-associations (HLA-Cw*0602 versus HLA-B*27, for example). In addition, there are numerous other genetic susceptibility loci (LCE3, CARD14, NOS2, NFKBIA, PSMA6, ERAP1, TRAF3IP2, IL12RB2, IL23R, IL12B, TNIP1, TNFAIP3, TYK2) and geoepidemiologic factors that contribute to the wide variability seen in psoriasis. Herein, we review the complex interplay between the genetic, cellular, ethnic, and geographic mediators of psoriasis, focusing on the shared mechanisms of PsV and PsA. </p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"58 1","pages":"87-99"},"PeriodicalIF":8.4,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86591429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-07-01DOI: 10.4103/0973-7847.194039
J Avinash, S Vinay, Kunal Jha, Diptajit Das, B S Goutham, Gunjan Kumar
Keeping an eye the escalating costs of dental services, the treatment cost of the consequences of dental caries can be reduced to manageable proportions by preventive measures aimed at decreasing the prevalence. One such measure is by increasing the consumption of caries preventive foods. Recently, there has been an upsurge of interest in mushrooms not only as a healthy food but also as a caries preventive food. The most common type of mushroom, Lentinula edodes also called as shiitake, is studied in-depth for its oral health benefits. The cultivation of shiitake dates way back to 1100 A.D. during the rule of Sung dynasty which is replaced by more modern and efficient sawdust substrate log cultures lately. Shiitake mushroom extract can be isolated in various forms such as freeze dried, oil, and ethyl acetate extracts. Various biologically active compounds such as erythritol, copalic acid, adenosine, carvacrol, and many more are responsible for this mushroom's antimicrobial activity. Anticariogenicity can be attributed to the induction of the detachment of cariogenic microorganisms from hydroxyapatite, changes in cell surface hydrophobicity, bactericidal activity, and disruption of signal transduction in Streptococcus mutans as proved through various in vivo and in vitro studies. Apart from these benefits, it has tremendous potential to be used as an antioxidant, anticancer, antigingivitis, antifungal, and antiviral agent. The one and only known adverse reaction due to shiitake mushroom consumption is the eruption of pruritic erythematous papules termed as shiitake dermatitis. This review highlights the unexplored anticaries potential of one such useful bioactive metabolite-shiitake mushroom.
{"title":"The Unexplored Anticaries Potential of Shiitake Mushroom.","authors":"J Avinash, S Vinay, Kunal Jha, Diptajit Das, B S Goutham, Gunjan Kumar","doi":"10.4103/0973-7847.194039","DOIUrl":"10.4103/0973-7847.194039","url":null,"abstract":"<p><p>Keeping an eye the escalating costs of dental services, the treatment cost of the consequences of dental caries can be reduced to manageable proportions by preventive measures aimed at decreasing the prevalence. One such measure is by increasing the consumption of caries preventive foods. Recently, there has been an upsurge of interest in mushrooms not only as a healthy food but also as a caries preventive food. The most common type of mushroom, Lentinula edodes also called as shiitake, is studied in-depth for its oral health benefits. The cultivation of shiitake dates way back to 1100 A.D. during the rule of Sung dynasty which is replaced by more modern and efficient sawdust substrate log cultures lately. Shiitake mushroom extract can be isolated in various forms such as freeze dried, oil, and ethyl acetate extracts. Various biologically active compounds such as erythritol, copalic acid, adenosine, carvacrol, and many more are responsible for this mushroom's antimicrobial activity. Anticariogenicity can be attributed to the induction of the detachment of cariogenic microorganisms from hydroxyapatite, changes in cell surface hydrophobicity, bactericidal activity, and disruption of signal transduction in <i>Streptococcus mutans</i> as proved through various <i>in vivo</i> and <i>in vitro</i> studies. Apart from these benefits, it has tremendous potential to be used as an antioxidant, anticancer, antigingivitis, antifungal, and antiviral agent. The one and only known adverse reaction due to shiitake mushroom consumption is the eruption of pruritic erythematous papules termed as shiitake dermatitis. This review highlights the unexplored anticaries potential of one such useful bioactive metabolite-shiitake mushroom.</p>","PeriodicalId":10674,"journal":{"name":"Collection of Czechoslovak Chemical Communications","volume":"7 1","pages":"100-104"},"PeriodicalIF":0.0,"publicationDate":"2016-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85751994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}