Health sciences review (Oxford, England)最新文献

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders following traumatic injury, affecting up to 51 % of adults admitted to trauma centres. Identification of people at risk of PTSD is an important component of holistic, evidence-based care in trauma centres. This is also increasingly becoming a recommendation across Level 1 Trauma Centres worldwide. The purpose of this paper was to systematically review published literature regarding factors that increase or decrease one's risk of PTSD within a year of admission to a trauma hospital. Systematic review methodology was implemented with utilisation of extensive search criteria. This broadened search strategy was used to address some identified limitations in titles and abstracts of relevant papers. Forward and backward citation of included papers was implemented to ascertain secondary sources. Titles, abstracts, and full texts were independently reviewed by two authors. Sixty-one papers met inclusion criteria and 58 predictors were analysed with at least one analysis. There was strong scientific evidence for assault, acute stress disorder, and baseline pain as predictors of PTSD. There was strong scientific evidence that age, education, ethnicity, premorbid health concerns, marital status, injury severity, mechanism of injury, and length of stay were not predictors. Several methodological concerns were identified across the included papers, such as heterogeneity in operational definitions of predictors and lack of application to theoretical frameworks of PTSD. Gaps remain in the literature regarding the impact of risk factors included in well-known frameworks such as the cognitive model of PTSD, requiring future research to inform appropriate early intervention in this at-risk population.

Brown adipocytes constitute a specialized tissue in heat build-up (i.e., thermogenesis) due to their mitochondrial uncoupling capacity, as they express thermogenic genes, playing a role in the energy metabolism of the whole body in mammals through non-shivering thermogenesis. Beige adipocytes originate in white adipose tissue (WAT) through the tissue browning process and are phenotypically similar to brown adipocytes. Considering that the activity of these cells is essential to reduce the incidence of metabolic diseases, including obesity, type 2 diabetes, and dyslipidemia, the stimulation of the brown fat and the development of beige adipose tissue has become a promising therapeutic target to treat clinical conditions. Due to the low amount of brown adipose tissue (BAT) in human adults, both phenomena (i.e., activation of brown and development of beige adipocytes) are related to better control of body weight, adiposity, insulin resistance, and hyperlipidemia. This review focuses on the comprehensively discussion of the metabolic importance of BAT activation and/or browning of WAT, and approaches that lead to the biogenesis of these thermogenic fats, such as cold exposure, thyroid hormones, physical exercise, diet and pharmacological agents (i.e., β3-adrenergic receptor agonist, glucagon-like peptide 1, mineralocorticoid receptor antagonists, ephedrine). These stimulatory agents have shown promise in activating BAT in humans. Frow our review, concluded that there are still many obstacles to be overcome in the upcoming years to better assess the real impact of BAT activation on metabolic health (i.e., absence of insulin resistance and metabolic syndrome), and elucidate many questions surrounding BAT physiology, so that this organ can indeed be considered an attractive therapeutic target for the prevention and reversal of obesity and metabolic disorders.

Gut bacteria plays a leading role in the pharmacological actions of both synthetic and natural product derived drugs. Their interactions are complex and bidirectional. This complexity with psychotropic phyto-compounds like delta-9-tetrahydrocannabinol (∆⁹-THC) (source: cannabis) has been found for modulating various brain functions including anxiety, depression, and cognition through an intricate cell-signaling network known as endocannabinoid system (ECS). This is a prominent neuromodulatory system that defines the host's health and disease. As a habit-forming weed, cannabis is associated with severe neuropsychiatric complications upon withdrawal. This is due to the dysregulation of monoamines (particularly dopamine and GABA) in the mesocorticolimbic circuit and hypothalamic-pituitary-adrenal axis. No notable pharmacotherapies are found for the treatment of cannabis dependence. Here, we postulate the connections between gut bacteria, CNS, ECS, and marijuana dependence, which would be an insight to overcome marijuana withdrawal symptoms.

Over the last 15 years, spray drying (SD), as an alternative to lyophilization, to manufacture and increase the stability of biologics has demonstrated promising outcomes. Pharmaceutical companies, on the other hand, have yet to expand technology for the production of aseptic spray-dried biologics. In this mini-review, we have discussed the limitations and potential of SD in biologics production.

Oroxylin A (ORA), a natural compound found in plants, has emerged as a promising therapeutic agent against liver fibrosis, cancer, and inflammatory diseases. Chronic inflammation fuels cancer development and progression by promoting cellular transformation, survival, invasion, and metastasis, while cancer can create an inflammatory microenvironment, further enhancing its growth and invasiveness. Inflammasome activation also plays a crucial role in liver fibrosis which is characterized by the abnormal accumulation of extracellular matrix components in the liver. This review aims to explore the efficacy of ORA and its mechanisms of action in these disease contexts. ORA targets hepatic stellate cells, key players in the development of liver fibrosis. By modulating signaling pathways such as transforming growth factor-beta (TGF-β), mitogen-activated protein kinase (MAPK) pathways, and nuclear factor-kappa B (NF-κB), ORA effectively inhibits HSC activation and reduces the production of excessive extracellular matrix proteins. ORA exhibits a multitude of beneficial effects in cancer treatment. It demonstrates anti-proliferative, pro-apoptotic, anti-metastatic, and anti-angiogenic properties by interfering with various molecular pathways involved in cancer progression. ORA displays anti-inflammatory properties by suppressing the production of proinflammatory cytokines and influencing signaling pathways. This mechanism allows ORA to mitigate inflammation, a hallmark of many diseases, including inflammatory conditions. The therapeutic potential of ORA opens up new avenues for drug discovery and development. Ongoing research focuses on exploring new plant sources and novel compounds to expand the range of natural therapeutic candidates. Overall, this review highlights the comprehensive potential of ORA as a safe therapeutic agent. In the field of chronic diseases, ORA has demonstrated anti-inflammatory, anti-fibrotic, and anti-cancer potentials, making it an interesting compound for research

Traumatic brain injury (TBI) represents a significant burden on individuals, societies, and healthcare systems as it is associated with long-term neurological and behavioral consequences. Although these effects vary according to severity, events that lead to TBI and mild TBI (mTBI), such as concussions, subconcussive impacts, and non-impact violent head movements, may also lead to similar changes. Soccer players are particularly prone to mTBI as they are exposed to head impacts in various ways during training and gameplay. A commonly-claimed TBI risk is that posed by the "heading" technique. Our examination of the literature questions the extent to which heading actually is a risk for TBI and mTBI vs other sources of head impact in soccer. Although headgear may protect against some impacts, it has not been widely adopted due to limited efficacy, practical limitations and potential changes to the heading technique. Nevertheless, accurate assessment of head impacts and other movements that may lead to TBI in soccer would be valuable to players, coaches, athletic and medical personnel. A potential method for accurately detecting head acceleration – a crucial element of most head injuries – is measurements through accelerometers. Here, we survey the different types of accelerometers and recent findings on their accuracy and feasibility among soccer players and offer suggestions for long-term research with these tools.

Lung transplantation has proven to be an effective treatment for end-stage lung diseases. Recognizing and acknowledging the effects of health inequities pertaining to lung transplants is important for under-resourced populations. This scoping review aims to map the extent of literature on health inequities corresponding to lung transplantation and point to knowledge gaps to direct future research. This scoping review followed guidelines from the Joanna Briggs Institute and the PRISMA extension for scoping reviews. In July 2022, we searched Ovid Embase and MEDLINE for published articles on lung transplants, published between 2011 and 2021, written in English, and examining at least one health inequity as defined by the NIH. Screening and charting were both performed in a masked, duplicate fashion. The frequency of each health inequity examined was analyzed, and findings from each included study were summarized. After screening, our sample contained 33 studies. Our findings illustrate that patients living further from lung transplant centers were less likely to be placed on the lung transplant waitlist. Further, non-white patients, women, and people who lived in low-income areas were less likely to undergo lung transplantation. Non-white patients also experienced increased mortality post-lung transplantation. Significant research gaps were found regarding the LGBTQ+ community, occupational status, income, and education level. This scoping review highlights the gaps in research regarding lung transplant inequities. To improve existing research gaps, we recommend research into the following: (1) intervention studies, (2) clinical bias, (3) donor education programs and follow-up studies, and (4) geographic information systems.

About 42 % of drugs with market acceptance and 92 % of drugs in the discovery pipeline are imperfectly aqueous soluble with insufficient intestinal absorption and will suffer from low oral bioavailability. Alkaloids are a group of phytonutrients that has been examined broadly due to their various health-related benefits. However, most of the alkaloids are considered as compounds with less aqueous solubility which limits their human usefulness. Piperine (PIP) is a family of nitrogenous aggregates that are extracted from the black pepper (Piper nigrum). It holds various therapeutic effects such as antioxidant, anti-inflammatory, neuroprotective, anti-cancer, anti-microbial, hepatoprotective, anti-depressant, anti-obesity, cardioprotective, P-gp inhibitor, anti-aging, and permeation enhancer. Although both the preclinical and clinical studies confirmed the advantages of PIP, its clinical usefulness is restricted due to its low water solubility and poor bioabsorption. To overcome these limitations nanoformulation is a widely employed approach. Multiple reviews have confirmed PIP health-related benefits, still, there is a lack of comprehensive review focused on its chemistry, pharmacological effects, nanoformulation, toxicity, advantages and challenges of PIP nanosystem, and marketed herbal formulations. However, this study aims to deliver a review of several nanoformulation development and nano-technology-based approaches employed to upregulate the solubility, bioabsorption, and therapeutic efficiency of PIP. We have also reviewed information related to the toxicity of PIP and its formulations.

Diabetes mellitus and osteoporosis are chronic illnesses associated with adverse health outcomes. Studies have reported common linkages between energy and bone metabolism. Specifically, significant effect of glucose metabolism on bone homoeostasis has improved the understanding of hyperglycaemia-induced bone degeneration. The study of skeletal endocrinology has also enabled the elucidation of pathways involved in glucose associated abnormality in bone homoeostasis. Insulin is central molecule in glucose and bone homoeostasis. Bone markers like osteocalcin, bone morphogenic protein and sclerostin control both bone and glucose metabolism. The interaction between gut-bone axis is mainly mediated by incretins. These hormones exert anabolic effect and alter bone remodelling process by enhancing bone alkaline phosphatase activity and type-1 collagen levels. Additionally, incretins also exhibit anti-inflammatory and anti-oxidative properties. Incretin degradation is mediated by Dipeptidyl Peptidase-4 (DPP-4), which is reported to be elevated in patients with osteoporosis. This association of incretins and bone homoeostasis possesses untapped therapeutic potential which needs to be further explored. In view of the concomitant occurrence, the present review summarises the correlation between diabetes mellitus, osteoporosis, incretins and DPP-4 and discusses the current evidence on DPP-4 inhibitors as new therapeutic alternative for osteoporosis.