Αρχειοθήκη ιστολογίου

Σάββατο 21 Οκτωβρίου 2017

Death by Gun Violence-A Public Health Crisis.

Death by Gun Violence-A Public Health Crisis.

JAMA Otolaryngol Head Neck Surg. 2017 Oct 09;:

Authors: Bauchner H, Rivara FP, Bonow RO, Bressler NM, Disis MLN, Heckers S, Josephson SA, Kibbe MR, Piccirillo JF, Redberg RF, Rhee JS, Robinson JK

PMID: 29052718 [PubMed - as supplied by publisher]



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Preservation of Stem Cells in Androgenetic Alopecia

Abstract

Androgenetic alopecia is characterized by progressive, patterned hair loss from the scalp that occurs in both men and women. Suggested that genetically predisposed hair follicles are target for androgen-stimulated follicle miniaturization, with gradual replacement of terminal hairs by vellus hairs. We aimed at evaluating the expression of stem and progenitor cell markers using IHC in scalp biopsies from affected and unaffected areas of patients with AGA.

This article is protected by copyright. All rights reserved.



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Molecular Targets for Pain Management: More Than Just Mu

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Basic/Translational Development of Forthcoming Opioid- and Nonopioid-Targeted Pain Therapeutics

imageOpioids represent an efficacious therapeutic modality for some, but not all pain states. Singular reliance on opioid therapy for pain management has limitations, and abuse potential has deleterious consequences for patient and society. Our understanding of pain biology has yielded insights and opportunities for alternatives to conventional opioid agonists. The aim is to have efficacious therapies, with acceptable side effect profiles and minimal abuse potential, which is to say an absence of reinforcing activity in the absence of a pain state. The present work provides a nonexclusive overview of current drug targets and potential future directions of research and development. We discuss channel activators and blockers, including sodium channel blockers, potassium channel activators, and calcium channel blockers; glutamate receptor–targeted agents, including N-methyl-D-aspartate, α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, and metabotropic receptors. Furthermore, we discuss therapeutics targeted at γ-aminobutyric acid, α2-adrenergic, and opioid receptors. We also considered antagonists of angiotensin 2 and Toll receptors and agonists/antagonists of adenosine, purine receptors, and cannabinoids. Novel targets considered are those focusing on lipid mediators and anti-inflammatory cytokines. Of interest is development of novel targeting strategies, which produce long-term alterations in pain signaling, including viral transfection and toxins. We consider issues in the development of druggable molecules, including preclinical screening. While there are examples of successful translation, mechanistically promising preclinical candidates may unexpectedly fail during clinical trials because the preclinical models may not recapitulate the particular human pain condition being addressed. Molecular target characterization can diminish the disconnect between preclinical and humans' targets, which should assist in developing nonaddictive analgesics.

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Unraveling the Mystery of THC: Cannabinoids and Neuropathic Pain

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Selective Cannabinoids for Chronic Neuropathic Pain: A Systematic Review and Meta-analysis

imageBACKGROUND: BACKGROUND:There is a lack of consensus on the role of selective cannabinoids for the treatment of neuropathic pain (NP). Guidelines from national and international pain societies have provided contradictory recommendations. The primary objective of this systematic review and meta-analysis (SR-MA) was to determine the analgesic efficacy and safety of selective cannabinoids compared to conventional management or placebo for chronic NP. METHODS: METHODS:We reviewed randomized controlled trials that compared selective cannabinoids (dronabinol, nabilone, nabiximols) with conventional treatments (eg, pharmacotherapy, physical therapy, or a combination of these) or placebo in patients with chronic NP because patients with NP may be on any of these therapies or none if all standard treatments have failed to provide analgesia and or if these treatments have been associated with adverse effects. MEDLINE, EMBASE, and other major databases up to March 11, 2016, were searched. Data on scores of numerical rating scale for NP and its subtypes, central and peripheral, were meta-analyzed. The certainty of evidence was classified using the Grade of Recommendations Assessment, Development, and Evaluation approach. RESULTS: RESULTS:Eleven randomized controlled trials including 1219 patients (614 in selective cannabinoid and 605 in comparator groups) were included in this SR-MA. There was variability in the studies in quality of reporting, etiology of NP, type and dose of selective cannabinoids. Patients who received selective cannabinoids reported a significant, but clinically small, reduction in mean numerical rating scale pain scores (0–10 scale) compared with comparator groups (−0.65 points; 95% confidence interval, −1.06 to −0.23 points; P = .002, I2 = 60%; Grade of Recommendations Assessment, Development, and Evaluation: weak recommendation and moderate-quality evidence). Use of selective cannabinoids was also associated with improvements in quality of life and sleep with no major adverse effects. CONCLUSIONS: CONCLUSIONS:Selective cannabinoids provide a small analgesic benefit in patients with chronic NP. There was a high degree of heterogeneity among publications included in this SR-MA. Well-designed, large, randomized studies are required to better evaluate specific dosage, duration of intervention, and the effect of this intervention on physical and psychologic function.

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Themed Issue on the Opioid Epidemic: What Have We Learned? Where Do We Go From Here?

No abstract available

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