British medical bulletin
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Obeticholic acid (OCA) is a semi-synthetic hydrophobic bile acid (BA) analogue that is highly selective agonist of farnesoid X receptor (FXR), a key nuclear BA receptor, which induces expression of gut-derived hormones, in particular fibroblast growth factor 19. The resulting beneficial effects of OCA on glucose and lipid metabolism and particularly hepatic inflammation make it a candidate for the treatment of a variety of conditions including primary biliary cholangitis (PBC) and nonalcoholic steatohepatitis (NASH). ⋯ New FXR agonists with a lower rate of side effects are being developed and trialed. Combination therapy with other agents may offer increased efficacy.
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A very large number of studies have reported a stalling of health improvements in the UK since 2010. ⋯ These findings point to a need for greater investment in research on the political determinants of health, on the timely detection and interpretation of evidence of worsening health, and on how political and policy processes respond to such findings.
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The regulatory role of microRNA (miRNA) in several conditions has been studied, but their function in tendon healing remains elusive. This review summarizes how miRNAs are related to the pathogenesis of tendon injuries and highlights their clinical potential, focusing on the issues related to their delivery for clinical purposes. ⋯ Investigations ex vivo suggest therapeutic opportunities of miRNA for the management of tendon injuries. Given the poor pharmacokinetic properties of miRNAs, these must be delivered by an adequate adjuvant transport system.
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British medical bulletin · Dec 2019
ReviewThe temporal effect of intra-articular ozone injections on pain in knee osteoarthritis.
Osteoarthritis (OA) is a most common orthopaedic condition, often complicated by inflammatory features. ⋯ The lack of a clear protocol of use is a major limitation, and to date there is no clear evidence of long-term efficacy.
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British medical bulletin · Dec 2019
ReviewLiver abscess: diagnostic and management issues found in the low resource setting.
Liver abscesses are mainly caused by parasitic or bacterial infection and are an important cause of hospitalization in low-middle income countries (LMIC). The pathophysiology of abscesses is different depending on the etiology and requires different strategies for diagnosis and management. This paper discusses pathophysiology and epidemiology, the current diagnostic approach and its limitations and management of liver abscess in low resource settings. ⋯ The lack of a quick and reliable diagnostic strategy in the majority of LMIC makes selection of appropriate treatment challenging.