ResearchPad - state-of-the-art-review https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[How the World’s Children Hear: A Narrative Review of School Hearing Screening Programs Globally]]> https://www.researchpad.co/article/elastic_article_14892 School hearing screening may mitigate the effects of childhood hearing loss through early identification and intervention. This study provides an overview of existing school hearing screening programs around the world, identifies gaps in the literature, and develops priorities for future research.Data SourcesA structured search of the PubMed, Embase, and Cochrane Library databases.Review MethodsA total of 65 articles were included according to predefined inclusion criteria. Parameters of interest included age groups screened, audiometric protocols, referral criteria, use of adjunct screening tests, rescreening procedures, hearing loss prevalence, screening test sensitivity and specificity, and loss to follow-up.ConclusionsSchool hearing screening is mandated in few regions worldwide, and there is little accountability regarding whether testing is performed. Screening protocols differ in terms of screening tests included and thresholds used. The most common protocols included a mix of pure tone screening (0.5, 1, 2, and 4 kHz), otoscopy, and tympanometry. Estimates of region-specific disease prevalence were methodologically inaccurate, and rescreening was poorly addressed. Loss to follow-up was also a ubiquitous concern.Implications for PracticeThere is an urgent need for standardized school hearing screening protocol guidelines globally, which will facilitate more accurate studies of hearing loss prevalence and determination of screening test sensitivity and specificity. In turn, these steps will increase the robustness with which we can study the effects of screening and treatment interventions, and they will support the development of guidelines on the screening, diagnostic, and rehabilitation services needed to reduce the impact of childhood hearing loss. ]]> <![CDATA[COVID-19 Clinical Trials]]> https://www.researchpad.co/article/elastic_article_13757 The coronavirus disease-2019 (COVID-19) pandemic has resulted in a proliferation of clinical trials designed to slow the spread of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Many therapeutic agents that are being used to treat patients with COVID-19 are repurposed treatments for influenza, Ebola, or for malaria that were developed decades ago and are unlikely to be familiar to the cardiovascular and cardio-oncology communities. Here, the authors provide a foundation for cardiovascular and cardio-oncology physicians on the front line providing care to patients with COVID-19, so that they may better understand the emerging cardiovascular epidemiology and the biological rationale for the clinical trials that are ongoing for the treatment of patients with COVID-19.

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<![CDATA[COVID-19 for the Cardiologist]]> https://www.researchpad.co/article/elastic_article_13756 Coronavirus disease-2019 (COVID-19), a contagious disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has reached pandemic status. As it spreads across the world, it has overwhelmed health care systems, strangled the global economy, and led to a devastating loss of life. Widespread efforts from regulators, clinicians, and scientists are driving a rapid expansion of knowledge of the SARS-CoV-2 virus and COVID-19. The authors review the most current data, with a focus on the basic understanding of the mechanism(s) of disease and translation to the clinical syndrome and potential therapeutics. The authors discuss the basic virology, epidemiology, clinical manifestation, multiorgan consequences, and outcomes. With a focus on cardiovascular complications, they propose several mechanisms of injury. The virology and potential mechanism of injury form the basis for a discussion of potential disease-modifying therapies.

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<![CDATA[Iron and Heart Failure]]> https://www.researchpad.co/article/N88483ef8-1e58-44e9-a46b-d99f71d84f29

Highlights

  • Intravenous iron supplementation provides symptomatic relief in patients with heart failure and concomitant iron deficiency.

  • The current definition of iron deficiency based on ferritin <100 ng/ml or transferrin saturation <20% may not accurately reflect the levels of iron within tissue and cells. Therefore, intravenous iron may be administered to heart failure patients who do not require iron supplementation.

  • Intravenous administration of iron bypasses essential regulatory mechanisms and can cause endothelial damage via the production of reactive oxygen species.

  • Although iron should be given to patients with heart failure and iron deficiency, sufficient consideration should be given to the route of administration and the potential for adverse effects, especially in non–iron deficient patients.

  • Further research must be conducted to determine whether changes in the cellular and subcellular distribution of iron in patients with heart failure are compensatory and beneficial or maladaptive and potentiates disease.

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<![CDATA[A long journey for acute kidney injury biomarkers]]> https://www.researchpad.co/article/N5609cc71-50f5-49e5-9158-4c4638caa781

Abstract

Acute kidney injury (AKI) is a life-threatening illness that continues to have an in-hospital mortality rate of patients with AKI ranges from 20% to 50% or greater, depending on underlying conditions. However, it has only marginally declined over the past 25 years. Previous authoritative publications have been pointed out that the lack of useful biomarkers for AKI has limited progress in improving the outcomes of this disorder. The purpose of this paper is to review the recent biomarkers involved in the early detection of AKI and main reasons for the failure to identify new AKI biomarkers. So far, several new AKI biomarkers have been discovered and validated to improve early diagnosis, degree of severity, pathophysiology, differential diagnosis, prediction for major kidney adverse events (MAKE, risk groups for progressive renal failure, need for renal replacement therapy [RRT], or death). These biomarkers can be classified into functional, damage and pre-injury phase biomarkers. However, the clinical use of the studied biomarkers in AKI prediction remains unclear because large prospective multicenter trials have failed to demonstrate troponin-like diagnostic performance. Reasons for the failure to identify AKI biomarkers are the heterogeneity of AKI itself, biomarker limitations and long roads to the validation of candidates for new AKI biomarkers. In an effort to overcome these barriers to identifying new AKI biomarkers, kidney biopsy specimens should be obtained and assessed in human AKI populations. Research in this field should be carried out in a pan-social approach rather than conducted by just a few medical institutions.

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<![CDATA[Clonal Hematopoiesis: A New Step Linking Inflammation to Heart Failure]]> https://www.researchpad.co/article/N96298ecf-95b2-4571-a218-79566df707d9

Highlights

  • Clonal hematopoiesis is a common condition in the elderly that can result from the acquisition of somatic mutations in HSPCs that confer a selective advantage and allow for clonal cell expansion.

  • This clonal population of mutated HSPCs can give rise to leukocytes with altered immune properties, and this condition can adversely impact the cardiovascular system.

  • Clonal hematopoiesis may represent a new causal risk factor for cardiovascular disease that can add to the predictive value of the traditional risk factors.

  • Understanding the clonal hematopoiesis status of a patient could aid in the development of personalized strategies for anti-inflammatory therapies for cardiovascular disease.

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<![CDATA[Targeting the Mitochondria in Heart Failure]]> https://www.researchpad.co/article/N97c40d85-aac0-4cf9-aa43-bb87467b2b47

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<![CDATA[Acquired long QT syndrome in chronic kidney disease patients]]> https://www.researchpad.co/article/N16099e27-044e-4ca4-9b83-ee59c45bf376

Abstract

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in chronic kidney disease (CKD) patients. QT interval prolongation is a congenital or acquired condition that is associated with an increased risk of torsade de pointes (TdP), sudden cardiac death (SCD), and all-cause mortality in the general population. The prevalence of acquired long QT syndrome (aLQTS) is high, and various acquired conditions contribute to the prolonged QT interval in patients with CKD. More notably, the prolonged QT interval in CKD is an independent risk factor for SCD and all-cause mortality. In this review, we focus on the epidemiological characteristics, risk factors, underlying mechanisms and treatments of aLQTS in CKD, promoting the management of aLQTS in CKD patients.

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<![CDATA[Telomeres as Therapeutic Targets in Heart Disease]]> https://www.researchpad.co/article/N2f68b83e-3286-455c-be72-b857e192985f

Highlights

  • Age-associated CVDs impose a great burden on current health systems. Despite the fact that current strong evidence supports the links among aging, telomere attrition, and CVDs, there is no clear direction for the development of telomere therapeutics against CVDs.

  • This review focuses on immune modulation, CHIP, pharmaceutical interventions, and gene therapy for their therapeutic roles in age-associated CVDs.

  • The future goal of telomere cardiovascular therapy in young subjects is to prevent senescence and diseases, whereas in older adult subjects, the goal is restoration of cardiovascular functions. Further studies on the telomere-CHIP-atherosclerosis axis may shed insights on how to achieve these 2 different therapeutic targets.

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<![CDATA[Genes Associated with Thoracic Aortic Aneurysm and Dissection: 2019 Update and Clinical Implications]]> https://www.researchpad.co/article/Naf022138-2ea6-4200-ba87-51058f036815

Thoracic aortic aneurysm is a typically silent disease characterized by a lethal natural history. Since the discovery of the familial nature of thoracic aortic aneurysm and dissection (TAAD) almost 2 decades ago, our understanding of the genetics of this disorder has undergone a transformative amplification. To date, at least 37 TAAD-causing genes have been identified and an estimated 30% of the patients with familial nonsyndromic TAAD harbor a pathogenic mutation in one of these genes. In this review, we present our yearly update summarizing the genes associated with TAAD and the ensuing clinical implications for surgical intervention. Molecular genetics will continue to bolster this burgeoning catalog of culprit genes, enabling the provision of personalized aortic care.

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<![CDATA[Metabolic Concepts in Idiopathic Intracranial Hypertension and Their Potential for Therapeutic Intervention]]> https://www.researchpad.co/article/5c94e6ced5eed0c48465332c

Background:

Traditional risk factors associated with idiopathic intracranial hypertension (IIH) include obesity, weight gain, and female sex. The incidence of IIH is increasing and yet the underlying trigger and the fueling pathological mechanisms are still poorly understood.

Evidence Acquisition:

Review of ophthalmology, neurology, general surgery, obesity, endocrinology, nutrition, and neurosurgery literature was made.

Results:

The facts that implicate sex and obesity in IIH and headache are examined. The role of fat distribution in IIH is questioned, and the concept of adipose tissue functioning as an endocrine organ driving IIH is discussed. The impact of androgen metabolism in IIH is reviewed as is the emerging role of glucagon-like-peptide-1 analogues in modulating intracranial pressure. This introduces the concept of developing targeted disease-modifying therapeutic strategies for IIH.

Conclusions:

This review will discuss the possible role of the adipose/gut/brain metabolism axis in IIH and speculate how this may impact the pathogenesis of IIH and therapeutic opportunities.

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<![CDATA[Renal structural image processing techniques: a systematic review]]> https://www.researchpad.co/article/5c801531d5eed0c484a9ee40

Abstract

Background and objective: Renal disease, such as nephritis and nephropathy, is very harmful to human health. Accordingly, how to achieve early diagnosis and enhance treatment for kidney disorders would be the important lesion. Nevertheless, the clues from the clinical data, such as biochemistry examination, serological examination, and radiological studies are quite indirect and limited. It is no doubt that pathological examination of kidney will supply the direct evidence. There is a requirement for greater understanding of image processing techniques for renal diagnosis to optimize treatment and patient care.

Methods: This study aims to systematically review the literature on publications that has been used image processing methods on pathological microscopic image for renal diagnosis.

Results: Nine included studies revealed image analysis techniques for the diagnosis of renal abnormalities on pathological microscopic image, renal image studies are clustered as follows: Glomeruli Segmentation and analysis of the Glomerular basement membrane (55/55%), Blood vessels and tubules classification and detection (22/22%) and The Grading of renal cell carcinomas (22/22%).

Conclusions: A medical image analysis method should provide an auto-adaptive and no external-human action dependency. In addition, since medical systems should have special characteristics such as high accuracy and reliability then clinical validation is highly recommended. New high-quality studies based on Moore neighborhood contour tracking method for glomeruli segmentation and using powerful texture analysis techniques such as the local binary pattern are recommended.

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