1,721,008 research outputs found
Understanding Childhood Neuroimmune Diseases of the Central Nervous System
Full text linkImmune-mediated diseases of the central nervous system (CNS) in childhood are a heterogeneous group of rare conditions sharing the inflammatory involvement of the CNS. This review highlights the growing knowledge of childhood neuroimmune diseases that primarily affect the CNS, outlining the clinical and diagnostic features, the pathobiological mechanisms and genetics, current treatment options, and emerging challenges. The clinical spectrum of these conditions is increasingly expanded, and the underlying mechanisms of dysregulation of the immune system could vary widely. Cell-mediated and antibody-mediated disorders, infection-triggered and paraneoplastic conditions, and genetically defined mechanisms can occur in previously healthy children and can contribute to different stages of the disease. The careful evaluation of the clinical presentation and temporal course of symptoms, the specific neuroimaging and immunological findings, and the exclusion of alternative causes are mandatory in clinical practice for the syndromic diagnosis. A common feature of these conditions is that immunotherapeutic agents could modulate the clinical course and outcomes of the disease. Furthermore, specific symptomatic treatments and comprehensive multidisciplinary care are needed in the overall management. We focus on recent advances on immune-mediated demyelinating CNS disorders, autoimmune encephalitis, interferonopathies, and possible neuroimmune disorders as Rasmussen encephalitis. Better knowledge of these conditions could allow prompt diagnosis and targeted immunotherapy, to decrease morbidity and mortality as well as to improve clinical outcomes, reducing the burden of the disease due to possible long-term neuropsychiatric sequelae. Persisting controversies remain in the rigorous characterization of each specific clinical entity because of the relative rarity in children; moreover, in a large proportion of suspected neuroimmune diseases, the immune "signature" remains unidentified; treatment guidelines are mostly based on retrospective cohort studies and expert opinions; then advances in specific molecular therapies are required. In the future, a better characterization of specific immunological biomarkers may provide a useful understanding of the underlying pathobiological mechanisms of these conditions in order to individualize more tailored therapeutic options and paradigms. Multicenter collaborative research on homogeneous groups of patients who may undergo immunological studies and therapeutic trials could improve the characterization of the underlying mechanisms, the specific phenotypes, and tailored management
Review of the literature on current changes in the timing of pubertal development and the incomplete forms of early puberty
Full text linkPuberty is a sensitive period of life characterized by the appearance of secondary sex characteristics which leads to a complete sexual maturation. It physiologically starts between the age of 8 and 13 years in girls and 9 and 14 years in boys. In the last two decades several studies has showed that start of puberty has moved up to younger ages by 12-18 months and some of the hypothesis trying to explain this change include the role of nutritional status and obesity and the influence of extrinsic factors such as the exposure to the endocrine - disrupting chemicals (EDCs), too. The hypothalamic - hypophysis- gonadal axis develops during embryogenesis, and except for period of activation immediately after birth, remain suppressed until the onset of puberal development. At the beginning of puberty, the pulse generator is reactivated, probably due to progressive stimulatory influeces on GnRH neurons from glial signal and neurotrassitters. Kisspepin and its receptor play a fundamental role in this phase. Premature Pubarche / Adrenarche, Premature Thelarche, Premature Menarche are incomplete form of precocious pubertal development that have their origin in endocrine mechanisms that are only now beginning to be understood. It is important to distinguish these form from the complete ones in order to reassure patients and parents about the non- evolution of pubertal progression and avoiding non-useful treatments with analogous LHRH
Emotional dysregulation in anorexia nervosa: evidence mapping review psychological treatments
No full textIntroduction: Eating disorders, such as anorexia nervosa, bulimia nervosa and binge-eating disorder, are complex psychiatric disorders characterized by compensatory and restrictive behavior and preoccupation with one's body. They occur in early and late adolescence, especially among girls. Eating and purging behaviors are considered dysfunctional emotional regulation strategies. Therefore, psychological treatment is essential. The most common psychological interventions are: dialectical behavioral therapy (DBT), cognitive-behavioral therapy (CBT), family therapy (FBT), multi-family group therapy (MFTG) and mentalization-based treatment (MBT). The aim of this review is to summarize the current evidence on the impact of psychological treatments on emotional regulation difficulties and psychological symptoms in patients with eating disorders, especially anorexia nervosa. Method: A search was conducted on PubMed and Web of Science using the terms “anorexia nervosa” and “emotion dysregulation”. Of the 278 initial articles, we included 15 publications. Results: The results indicate that the acquisition of new coping strategies, through DBT, leads to an improvement in anxiety and alexithymia. DBT, CBT and MBT lead to a reduction in the use of dysfunctional emotional regulation strategies too. Conclusion: Eating disorders involve both physical and mental health; therefore, it’s desirable for future research to focus on the mutual synergy between the mental and physical component by evaluating various factors such as biomarkers and the most appropriate therapeutic approach with respect to the treatment setting
The Effects of the Ukrainian Conflict on Oncological Care: The Latest State of the Art
No full textBackground: The COVID-19 pandemic has dramatically affected all aspects of the patient’s
pathway to cancer diagnosis and subsequent treatment. Our main objective was to evaluate the status
of cancer trials in Ukraine as of September 2022. Methods: Initially, we examined with a narrative
review the state of breast, colorectal, and cervical cancer population-based screening. Subsequently,
we assessed each trial status for the years 2021 and 2022. Results: Estimates of participation in breast
and cervical cancer screening are different from region to region. Moreover, regarding cervical cancer
screening, extremely different participation estimates were reported: 73% in 2003 vs. <10% 2020.
Our data show that from 2014 to 2020, despite the pandemic, cancer trials in Ukraine significantly
increased from 27 to 44. In 2021 no trials were completed; in fact, we observed that out of 41 trials,
8 were active not recruiting, 33 were recruiting, and 0 were completed or terminated. In 2022 in
Ukraine, for oncological pathologies, only 3 trials were registered, while in 2021, 41 trials were
registered. The suspension of trials regarded above all concern hematological tissue (66.7%) and the
genitourinary tract (60%). Conclusions: Our work has highlighted how the areas most affected by the
conflict present criticalities in oncological care
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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