Articles: patients.
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Bronchopulmonary dysplasia (BPD) is a chronic lung disease, with its own clinical, radiological, and histopathological characteristics, which mainly affects premature newborns (NBs), resulting from a combination of factors that include immaturity, inflammation, and lung injury, in addition to therapy with mechanical ventilation and exposure to high concentrations of oxygen. However, even with advances in care for critically ill NBs, BPD continues to be a challenge for the care team and family members. This has been identified as one of the most important causes of morbidity and mortality due to prematurity and can have significant impacts on the quality of life of the affected patients. ⋯ Genetic variants in the glutathione S-transferase Mu-1/glutathione S-transferase theta-1-null (GSTM1/GSTT1) genes may be associated with a greater risk of developing BPD in premature NBs, as they affect the function of glutathione S-transferases (GSTs) enzymes and, consequently, the body's ability to eliminate toxic or harmful pro-inflammatory substances. GSTM1/GSTT1-null individuals, due to the absence of gene expression, present loss of enzymatic activity of the respective GST enzymes, triggering failures in the detoxification process and the consequent development of numerous diseases resulting from oxidative damage such as infertility, chronic kidney disease, eryptosis, retinopathy of prematurity, necrotizing enterocolitis, periventricular leukomalacia, intraventricular hemorrhage. The objective of this narrative review was to highlight the role of genetic variants in the GSTM1/GSTT1 genes in the onset of BPD.
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J Pain Symptom Manage · Jan 2025
ReviewEarly Integration of Palliative Care in Non-Oncological Patients: A Systematic Review.
Palliative care (PALC) is traditionally linked to end-of-life cancer care but also benefits advanced nononcological diseases. ⋯ The impact of early PALC on health outcomes in nononcological diseases is inconsistent. Addressing barriers to early PALC integration and conducting further high-quality research are essential for optimizing care pathways and enhancing patient outcomes.
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Trials of endovascular therapy for basilar artery occlusion, including vertebral occlusion extending into the basilar artery, have shown inconsistent results. We aimed to pool data to estimate safety and efficacy and to explore the benefit across pre-specified subgroups through individual patient data meta-analysis. ⋯ None.
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Migraine is a common primary headache disorder, less frequently affecting men than women, and often regarded as predominantly a "women's disease." Despite this, migraine in men presents with unique characteristics in terms of symptoms, treatment responses, comorbidities, and pain perception. Historically, research has focused more on migraine in women, overlooking critical male-specific aspects. ⋯ Men are underrepresented in clinical migraine research. In contrast, preclinical studies often focus solely in male animals as a result of various misconceptions. This disparity necessitates greater focus on sex-specific aspects of migraine to enhance diagnosis, treatment, and research. Addressing stigma, increasing healthcare access, and ensuring balanced sex and gender representation in future studies is crucial for a comprehensive understanding and effective management of migraine for all patients.
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Status epilepticus is a common neurological emergency that is characterised by prolonged or recurrent seizures without recovery between episodes and associated with substantial morbidity and mortality. Prompt recognition and targeted therapy can reduce the risk of complications and death associated with status epilepticus, thereby improving outcomes. The most recent International League Against Epilepsy definition considers two important timepoints in status epilepticus: first, when the seizure does not self-terminate; and second, when the seizure can have long-term consequences, including neuronal injury. ⋯ If status epilepticus continues, management should entail second-line and third-line treatment agents, supportive EEG monitoring, and admission to an intensive care unit. Future research to study early seizure detection, rescue protocols and medications, rapid treatment escalation, and integration of fundamental scientific and clinical evidence into clinical practice could shorten seizure duration and reduce associated complications. Furthermore, improved recognition, education, and treatment in patients who are at risk might help to prevent status epilepticus, particularly for patients living in low-income and middle-income countries.