J Formos Med Assoc
-
The 2019 Nobel Prize in Physiology or Medicine was awarded to William G. Kaelin Jr, Sir Peter J. Ratcliffe, and Gregg L. ⋯ Next, the biology of HIF in the kidney will be reviewed. Studies on the HIF stabilizers in the context of kidney disease, as well as the manipulation of HIF in different renal cell types will be covered. Lastly, the clinical application of HIF stabilizers and HIF antagonists for the treatment of anemia and cancer, respectively, will be discussed.
-
Unimpaired activities of daily living (ADL) is essential for the diagnosis of normal cognition and mild cognitive impairment. However, diagnosis according to this concept is difficult to apply to patients comorbid with motor dysfunction. We aim to use a novel ADL questionnaire for operationally diagnosing unimpaired ADL in vascular cognitive impairment with no dementia (VCIND). ⋯ Our study showed that HAI-ADL provides an operational determinates unimpaired ADL which is necessary for the diagnosis of VCIND. The predictive value for progression to dementia was proved by a long-term follow-up analysis of the research cohort.
-
Cryptogenic stroke comprises about one-quarter of ischemic strokes with high recurrence rate; however, studies specifically investigating the features and treatment of this stroke subtype are rare. The concept of 'embolic stroke of undetermined source' (ESUS) may facilitate the development of a standardized approach to diagnose cryptogenic stroke and improve clinical trials. Since recent large randomized control trials failed to demonstrate a reduction in stroke recurrence with anticoagulants, anti-platelet agents remain the first-line treatment for ESUS patients. ⋯ Anticoagulant treatments may still benefit some subgroups of high-risk ESUS patients, such as those with multiple infarcts at different arterial territories without aortic atheroma, the elderly, or patients with high CHA2D2-VASc or HOVAC scores, atrial cardiopathy or patent foramen ovale. Several important ESUS clinical trials are ongoing, and the results are anticipated. With rapid progress in our understanding of ESUS pathophysiology, new subcategorizations of ESUS and assignment of optimal treatments for each ESUS subgroup are expected in the near future.
-
Review
Role of nutrition in the development and prevention of age-related hearing loss: A scoping review.
Age-related hearing loss (ARHL) is a major and increasingly prevalent health problem worldwide, causing disability and social isolation in the people who present it. This impairment is caused by genetic and environmental factors. Nutritional status has been identified as a related risk associated with hearing loss (HL). ⋯ Conversely, greater consumption of fruit and vegetables, and of polyunsaturated fatty acids (omega-3) and anti-oxidants in the form of vitamins A, C, and E, prevent the development of ARHL. The current literature suggests a possible association between nutritional status and hearing loss. More studies are needed to better characterize the clinical consequences of this association.
-
Meta Analysis
Efficacy of levetiracetam for migraine prophylaxis: A systematic review and meta-analysis.
Migraine is characterized by moderate to severe recurrent headache lasting for 4-72 h. Cortical hyperexcitability may play a crucial role in migraine onset. Therefore, antiepileptic drugs, such as levetiracetam, may be beneficial. ⋯ Our study indicated that levetiracetam can significantly reduce headache frequency and severity in adults and children. Thus, oral levetiracetam can be a therapeutic option for migraine prophylaxis, especially concerning with the adverse effects or teratogenicity of other preventive treatments.