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Bharati Kadamb Patel Kadamb H Patel Madhav Bhatia Shridhar Ganpati Iyer Krishnakumar Madhavan Shabbir M Moochhala 《World journal of gastroenterology : WJG》2021,27(30):5019-5036
The gut microbiome is a complex microbial community, recognized for its potential role in physiology, health, and disease. The available evidence supports the role of gut dysbiosis in pancreatic disorders, including acute pancreatitis (AP). In AP, the presence of gut barrier damage resulting in increased mucosal permeability may lead to translocation of intestinal bacteria, necrosis of pancreatic and peripancreatic tissue, and infection, often accompanied by multiple organ dysfunction syndrome. Preserving gut microbial homeostasis may reduce the systemic effects of AP. A growing body of evidence suggests the possible invo lvement of the gut microbiome in various pancreatic diseases, including AP. This review discusses the possible role of the gut microbiome in AP. It highlights AP treatment and supplementation with prebiotics, synbiotics, and probiotics to maintain gastrointestinal microbial balance and effectively reduce hospitalization, morbidity and mortality in an early phase. It also addresses novel therapeutic areas in the gut microbiome, personalized treatment, and provides a roadmap of human microbial contributions to AP that have potential clinical benefit. 相似文献
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Srividya N. Iyer Sally S. Mustafa Laura Moro G. Eric Jarvis Ridha Joober Sherezad Abadi Nicola Casacalenda Howard C. Margolese Amal Abdel-Baki Martin Lepage Ashok Malla 《Revue canadienne de psychiatrie》2021,66(5):468
Objective:We aimed to investigate whether individuals with first-episode psychosis (FEP) receiving extended early intervention (EI) were less likely to experience suicidal ideation and behaviors than those transferred to regular care after 2 years of EI. Another objective was to examine the 5-year course of suicidality in FEP.Methods:We conducted a secondary analysis of a randomized controlled trial where 220 patients were randomized after 2 years of EI to receive extended EI or regular care for the subsequent 3 years. Suicidality was rated using the Brief Psychiatric Rating Scale. Linear mixed model analysis was used to study time and group effects on suicidality.Results:Extended EI and regular care groups did not differ on suicidality. There was a small decrease in suicidality over time, F(7, 1038) = 1.84, P = 0.077, with an immediate sharp decline within a month of treatment, followed by stability over the remaining 5 years. Patients who endorsed suicidality at entry (46.6%) had higher baseline positive, negative, and depressive symptoms. The 5-year course fell in 3 groups: never endorsed suicidality (33.9%), endorsed suicidality at low-risk levels (43.1%), and endorsed high-risk levels (23.0%). The high-risk group had a higher proportion of affective versus nonaffective psychosis diagnosis; higher baseline positive and depressive symptoms; higher 5-year mean depression scores, and fewer weeks of positive symptom remission over the 5-year course.Conclusions:The first month of treatment is a critical period for suicide risk in FEP. Although early reductions in suicidality are often maintained, our findings make the case for sustained monitoring for suicide risk management. 相似文献
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M. Potrony J.A. Puig-Butille M. Ribera-Sola V. Iyer C.D. Robles-Espinoza P. Aguilera C. Carrera J. Malvehy C. Badenas M.T. Landi D.J. Adams S. Puig 《The British journal of dermatology》2019,181(1):105-113
Melanoma is an aggressive type of skin cancer. Each year more than 250,000 new cases are diagnosed worldwide. If diagnosed at early stages, melanoma can be cured with relatively simple surgery. Globally, 20% of melanoma patients will die, but when diagnosed with thick (more advanced / later stage) tumours, the probability of dying increases by up to 60%. The best strategy to improve survival is with early diagnosis. The identification of people at risk is essential. Around 10% of cases occur in a familial context. This means that these individuals have an inherited genetic risk of developing melanoma explained by the presence of alterations (mutations) in specific genes. In a family with known mutation, healthy individuals who carry the mutation can be included in early detection programs that allow the diagnosis of melanomas at early stages. But the gene/genes responsible for this risk is still unknown in more than 70% of families. This study, from Spain, aimed to evaluate the prevalence of mutations in two genes (POT1 and TERT) in Spanish melanoma-prone families without known mutated genes. The authors sequenced (a way of studying) both genes in cases from 228 families. They found mutations in nearly 2% of the families assessed. They additionally identified two patients in two families who also had thyroid malignances. If this is confirmed in additional studies, the melanoma-prone families with mutations in this gene will also benefit from early diagnosis of thyroid tumours. No mutations were identified in TERT promoter indicating that this gene does not play an important role in familial melanoma susceptibility in Spain. 相似文献
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