查看更多>>摘要：Almost three decades ago Dr。 Nikolaev and co-authors reported a remarkable finding that a single-course low volume hemoperfusion through uncoated spherical activated carbon led to a significant increase in survival of dogs acutely irradiated with X-rays of the dose of 5。25 Gy (Artif。 Organs。 1993; 17: 362-8)。 In those studies， the adsorptive detoxification， which is characteristic for carbon adsorbents， was less likely to play a predominant role in radioprotection， thus prompting the authors to assume that some other， unknown， mechanisms were involved。 This article is aimed to interpret the radioprotective effect of activated carbon， based on the mounting evidence that it is capable of reducing the oxidative stress and promoting the recovery in various tissues and organs (including hematopoietic) with an active involvement of relatively radioresistant tissue-resident macrophages。
Van Damme, WimDahake, Ritwikvan de Pas, RemcoVanham, Guido...
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查看更多>>摘要：The variation in the speed and intensity of SARS-CoV-2 transmission and severity of the resulting COVID-19 disease are still imperfectly understood。 We postulate a dose-response relationship in COVID-19， and that "the dose of virus in the initial inoculum" is an important missing link in understanding several incompletely explained observations in COVID-19 as a factor in transmission dynamics and severity of disease。 We hypothesize that: (1) Viral dose in inoculum is related to severity of disease， (2) Severity of disease is related to transmission potential， and (3) In certain contexts， chains of severe cases can build up to severe local outbreaks， and large-scale intensive epidemics。 Considerable evidence from other infectious diseases substantiates this hypothesis and recent evidence from COVID-19 points in the same direction。 We suggest research avenues to validate the hypothesis。 If proven， our hypothesis could strengthen the scientific basis for deciding priority containment measures in various contexts in particular the importance of avoiding super-spreading events and the benefits of mass masking。
查看更多>>摘要：Pyruvate dehydrogenase (PDH) deficiency is an inherited metabolic disorder caused by a defect in any subunit of the pyruvate dehydrogenase complex (PDHC)， which has an essential role in glucose metabolism。 The causes of disease progression in PDH deficiency are not fully understood yet。 Based on repeated observations of a patient with PDH deficiency at our center， we hypothesized that stress-induced gluconeogenesis contributes to rapid exacerbation of the disease。 This link has not been established previously。
Levenberg, KateHajnal, AndrasGeorge, Daniel R.Saunders, Erika F. H....
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查看更多>>摘要：Approximately 45 million people worldwide are diagnosed with bipolar disorder (BD)。 While there are many known risk factors and models of the pathologic processes influencing BD， the exact neurologic underpinnings of BD are unknown。 We attempt to integrate the existing literature and create a unifying hypothesis regarding the pathophysiology of BD with the hope that a concrete model may potentially facilitate more specific diagnosis， prevention， and treatment of BD in the future。 We hypothesize that dysfunctional signaling from the parvocellular neurons of the paraventricular hypothalamic nucleus (PVN) results in the clinical presentation of BD。 Functional damage to this nucleus and its signaling pathways may be mediated by myriad factors (e。g。 immune dysregulation and auto-immune processes， polygenetic variation， dysfunctional interhemispheric connections， and impaired or overactivated hypothalamic axes) which could help explain the wide variety of clinical presentations along the BD spectrum。 The neurons of the PVN regulate ultradian rhythms， which are observed in cyclic variations in healthy individuals， and mediate changes in functional hemispheric lateralization。 Theoretically， dysfunctional PVN signaling results in prolonged functional hemispheric dominance。 In this model， prolonged right hemispheric dominance leads to depressive symptoms， whereas left hemispheric dominance correlated to the clinical picture of mania。 Subsequently， physiologic processes that increase signaling through the PVN (hypothalamic-pituitaryadrenal axis， hypothalamic-pituitary-gonadal axis， and hypothalamic-pituitary-thyroid axis activity， suprachiasmatic nucleus pathways) as well as， neuro-endocrine induced excito-toxicity， auto-immune and inflammatory flairs may induce mood episodes in susceptible individuals。 Potentially， ultradian rhythms slowing with age， in combination with changes in hypothalamic axes and maturation of neural circuitry， accounts for BD clinically presenting more frequently in young adulthood than later in life。
查看更多>>摘要：Cancer cachexia (CC) is a progressive loss of muscle mass (with or without a decrease of adipose tissue)。 Gradual deterioration of the patient's fitness is resistant to nutritional intervention。 The biochemical foundation of observed catabolism， detrimental protein， and energy balance is complex。 However， the generalized inflammatory response plays a vital role。 It is a kind of cytokine storm， which involves increased activity of TNF-alpha， IL-1， IL-6， and INF-gamma。 Pharmacological treatment of cachexia consists mainly of progestagens and glucocorticosteroids。 Still， the assessment of new options limiting the harmful impact of cachexia could be beneficial。 Chloroquine (CQ) and hydroxychloroquine (HCQ) are old antimalarial agents endowed with immunomodulatory properties。 Being potent autophagy inhibitors， they could lead to a form of intracellular starvation in both cytokine-releasing cells and cancer cells， thus limiting the harmful impact of CC。 CQ and HCQ are also efficient in particular connective tissue disorders。 They have gained special attention since the World Health Organization announced the coronavirus disease 2019 (COVID-19) pandemic。 According to initial reports， people with a severe inflammatory reaction showed significant benefits。 Possibly they could not be attributed to the antiviral activity alone。 It is worth noting that the cytokine storm in COVID-19， connective tissue disorders， and cancer cachexia share some similarities。 Therefore， we hypothesize that low doses of CQ/HCQ may prove efficient in cancer cachexia。
查看更多>>摘要：Lipedema (LI) is a common yet misdiagnosed condition， often misconstrued with obesity。 LI affects women almost exclusively， and its painful and life-changing symptoms have long been thought to be resistant to the lifestyle interventions such as diet and exercise。 In this paper， we discuss possible mechanisms by which patients adopting a ketogenic diet (KD) can alleviate many of the unwanted clinical features of LI。 This paper is also an effort to provide evidence for the hypothesis of the potency of this dietary intervention for addressing the symptoms of LI。 Specifically， we examine the scientific evidence of effectiveness of adopting a KD by patients to alleviate clinical features associated with LI， including excessive and disproportionate lower body adipose tissue (AT) deposition， pain， and reduction in quality of life (QoL)。 We also explore several clinical features of LI currently under debate， including the potential existence and nature of edema， metabolic and hormonal dysfunction， inflammation， and fibrosis。 The effectiveness of a KD on addressing clinical features of LI has been demonstrated in human studies， and shows promise as an intervention for LI。 We hope this paper leads to an improved understanding of optimal nutritional management for patients with LI and stimulates future research in this area of study。
Romito, Giuseppe AlexandrePannuti, Claudio MendesRibeiro Reis, Isabella NemeLima Silva do Amaral, Guilherme Castro...
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查看更多>>摘要：Dental professionals work closely with patients and present an increased risk of person-to-person transmission of SARS-CoV-2。 Moreover， the use of ultrasonic scalers， air-water syringes， and slow and high-speed handpieces， which are common in the dental office， generate spatter and aerosol。 The use of preprocedural mouthrinses has been proposed to reduce the viral load in saliva and oropharyngeal tissues， thus decreasing viral load in dental aerosol。 Although some mouthrinses demonstrates an antiviral effect， there is limited evidence about the clinical efficacy of any mouthrinse in the reduction of SARS-CoV-2 in the dental aerosol。 We hypothesized that mouthrinses may reduce SARS-CoV-2 viral load in the oropharynx and its fluids reducing viral load in dental aerosol。 The potential use of mouthrinses is discussed， along with proposal of in vitro and clinical studies， in order to evaluate this hypothesis。 If this hypothesis holds true， dental professionals and patients may benefit from the routine use of preprocedural mouthrinses。
查看更多>>摘要：In the etiology of anxiety disorders， immune system and inflammation are suggested to play a role。 This study hypothesized that there is a relationship between anxiety disorders and inflammation。 This retrospective study included 131 children and adolescents between the ages 6-17 who were diagnosed with anxiety disorders。 Control group consisted of 131 healthy children with no history of psychiatric disorders or chronic inflammatory conditions。 White blood cell (WBC)， neutrophil (NEU)， lymphocyte， monocyte， basophil， eosinophil values and other hematological markers were noted。 From those values， neutrophil/lymphocyte ratio (NLR)， platelet/lymphocyte ratio (PLR)， monocyte/lymphocyte ratio (MLR)， and other ratios were calculated。 WBC and NEU values were significantly higher in children and adolescents with anxiety disorder compared to the control group。 In addition， NLR， MLR and PLR values were significantly higher than the control group。 Other measured parameters and calculated values did not differ between study groups。 No statistically significant difference was found between Generalized Anxiety Disorder (GAD) group， Social Anxiety Disorder group and Not Otherwise Specified Anxiety Disorders (AD-NOS) group in terms of hematological markers except RDW-CV。 Only RDW-CV was found statistically significantly higher in AD-NOS group compared to GAD。 These results show that there is an association between inflammation and anxiety disorders。 Also， it is postulated that hematological parameters can be used as a useful marker in the follow-up of patients with anxiety disorders。
NSTL
Elsevier