Recent advances in understanding schizophrenia

Summary

A hearing aid is designed to bring sounds, especially speech, more effectively to the ear of a person with hearing loss. Typically a person with sensorineural deafness has a raising of the thresholds of hearing and the basic principles of how the aid may overcome the loss is described.

Résumé

Chez une personne atteinte de surdité neuro-sensorielle, le port d'un appareil de correction auditive lui permet de recevoir plus efficacement les sons, en particulier la parole. L'élévation du seuil de l'ouïe ainsi que les principes de base du fonctionnement de l'appareil de correction auditive sont décrits par l'auteur.

Zusammenfassung

Ein Hilfsgerät für Gehörbehinderte ist so konstruiert, dass es Laute, insbesondere Gesprochenes, wirksamer bis zum Ohr eines Menschen mit Schwerhörigkeit bringt als dies unter physiologischen Bedingungen möglich ist. In typischen Fällen wird bei Patienten mit sensorisch-neuraler Taubheit die Reizschwelle des Gehörs auf diese Weise herabgesetzt. Abschliessend wird dargelegt, wie das Hörgerät den Hörverlust ausgleicht.

Résumen

El propósito de un audifono es Ilevar sonidos de forma más eficaz, y en especial el habla, al oido de la persona afecta de pérdida auditoria. Típicamente, una persona con sordera neurosensitiva experimenta una elevación de los umbrales auditorios, y se describen los principios básicos de la forma en que el audífono supera tal pérdida.     

Recent advances in understanding endothelial dysfunction in atherosclerosis

Over the last two decades, it has become evident that decreased bioavailability of endothelial nitric oxide (NO) produced from endothelial NO synthase (eNOS), referred to as endothelial dysfunction, plays a crucial role in the development and progression of atherosclerosis. Much progress has been made in understanding the mechanisms of decreased endothelial NO bioavailability at the levels of regulation of eNOS gene expression, eNOS enzymatic activity and NO inactivation. Initial studies suggest that increasing eNOS gene expression would improve endothelial NO release in the hope of inhibiting the progression of atherosclerosis. Recent experimental studies, however, do not always support this therapeutic concept and show some evidence that overexpression of eNOS in atherosclerosis may be even harmful for the disease progression.Thus, recent research to improve endothelial function in atherosclerosis has focused on regulation of eNOS enzymatic activity and prevention of NO inactivation by oxidative stress. Since the role of oxidative stress in endothelial NO bioavailability has been reviewed in a large number of comprehensive articles, this article focuses on the relevant regulatory mechanisms of eNOS enzymatic activity that are emerging to play a role in endothelial dysfunction in atherosclerosis.     

Recent advances in the treatment of hypertension

Uncontrolled blood pressure remains the single most common cause of death accounting for more than 7 million deaths per year worldwide. Despite the availability of potent lifestyle and pharmacologic approaches, rates of control of blood pressure are unsatisfactory and additional strategies to curb the burden of hypertension are warranted. Several novel pharmacological- and device-based approaches have recently been tested and may prove helpful to achieve better blood pressure control rates and thereby improve cardiovascular outcomes in patients with hypertension.     

Recent advances in the treatment of hypertension

Uncontrolled blood pressure remains the single most common cause of death accounting for more than 7 million deaths per year worldwide. Despite the availability of potent lifestyle and pharmacologic approaches, rates of control of blood pressure are unsatisfactory and additional strategies to curb the burden of hypertension are warranted. Several novel pharmacological- and device-based approaches have recently been tested and may prove helpful to achieve better blood pressure control rates and thereby improve cardiovascular outcomes in patients with hypertension.     

Recent advances in prenatal screening and diagnosis of genetic disorders

In any pregnancy, there is an approximate 3% to 5% chance that a fetal complication will occur. The most familiar prenatal diagnostics cannot be performed until the fetus is well into gestation, and most involve invasive procedures along with their inherent risks. In light of these facts, many noninvasive prenatal screening and diagnostic tests have been developed, the newest using recombinant deoxyribonucleic acid (DNA) technology in the examination of fetal cells. Through these procedures, genetic coding errors and chromosomal disruptions may be detected. This article discusses the currently available prenatal and screening diagnostic tests for genetic disorders with a focus on the latest technology.     

焦虑症的诊断和治疗

焦虑症又称焦虑性神经症,是指以广泛和持续性焦虑或反复发作的惊恐不安为主要特征的神经症。这些焦虑与惊恐不是由于现实生活事件或刺激而造成的,也不是某一种躯体疾病造成的;这种紧张程度与现实事件完全不相称,或生活事件程度不能解释这种焦虑不安的严重症状;经检查证实没有相应的器质性基础。包括了恐怖症、社交焦虑症、强迫性障碍、广泛性焦虑症（general anxiety disorders,GAD）和惊恐障碍（panic disorder,PD）、严重应激反应、躯体化障碍、转换障碍、疑病症等焦虑谱系,本文主要涉及GAD和PD。     

Recent advances in the treatment of hypertensive emergencies

Clinical practice varies regarding the choice of agent to treat hypertensive emergencies. With the development of national guidelines, a standardized pharmacotherapeutic approach would be recommended on the basis of evidence in the published literature. Such an approach might decrease the variability among practitioners and institutions in the treatment of hypertensive emergencies. Each available agent to treat hypertensive emergencies possesses both positive and negative attributes. With several intravenous, short-acting, agents available, clinicians must make educated decisions about the best medication for their patients, and these decisions should be based on organ function as well as the patient's clinical presentation. The primary goal in hypertensive emergencies is to rapidly and safely reduce blood pressure to prevent further end-organ damage. Critical care nurses have an important role in the safe and effective management of these patients. The application of knowledge of treatment goals, hemodynamic monitoring, and pharmacological therapy for hypertensive emergencies can lead to the safe recovery of these critically ill patients.     

Recent advances in the treatment of rheumatoid arthritis

Rheumatoid arthritis (RA) affects about 0.5% to 1% of the population worldwide. Because there is no cure for this disease, the goal of therapy is to control the underlying inflammatory process and maintain or improve function. This article reviews 4 new treatments for patients with RA: leflunomide, etanercept, infliximab, and the protein A immunoadsorption column with plasmapheresis therapy.     

Recent advances in the treatment of Brugada syndrome

Introduction: Brugada syndrome (BrS) is an inherited cardiac arrhythmia syndrome characterized by ST-segment elevation in right precordial ECG leads and associated with sudden cardiac death in young adults. The ECG manifestations of BrS are often concealed but can be unmasked by sodium channel blockers and fever.

Areas covered: Implantation of a cardioverter defibrillator (ICD) is first-line therapy for BrS patients presenting with prior cardiac arrest or documented VT. A pharmacological approach to therapy is recommended in cases of electrical storm, as an adjunct to ICD and as preventative therapy. The goal of pharmacological therapy is to produce an inward shift to counter the genetically-induced outward shift of ion channel current flowing during the early phases of the ventricular epicardial action potential. This is accomplished by augmentation of I_Ca using □□adrenergic agents or phosphodiesterase III inhibitors or via inhibition of I_to. Radiofrequency ablation of the right ventricular outward flow tract epicardium is effective in suppressing arrhythmogenesis in BrS patients experiencing frequent appropriate ICD-shocks.

Expert commentary: Understanding of the pathophysiology and approach to therapy of BrS has advanced considerably in recent years, but there remains an urgent need for development of cardio-selective and ion-channel-specific I_to blockers for treatment of BrS.     

Recent advances in the treatment of graft-versus-host disease

Graft-versus-host disease (GVHD) is a lethal complication of allogeneic hematopoietic stem cell transplantation (HSCT) where immunocompetent donor T cells attack the genetically disparate host cells. The predominant symptoms of acute GVHD occur in the skin, liver, and intestine. Induction of acute GVHD can be divided into three phases: recipient conditioning, donor T cell activation, and effector cell-mediated GVHD. Chronic GVHD usually appears up to 100 days after HSCT and is characterized by symptoms similar to those observed for autoimmune disease. It is possible that chronic GVHD is the result of autoreactive T cells that escaped negative selection due to damage to the thymus from conditioning regimens, acute GVHD, and/or age related atrophy. Recent advances in the understanding of the basic mechanisms involved in GVHD pathophysiology have led to new strategies designed to block GVHD. This review focuses on recent developments in the treatment of GVHD, including insights gained from our own experimental studies.     

Recent advances in the treatment of ARDS.

Despite more than 25 years of extensive research the mortality of ARDS patients remains high. Besides the often deleterious course of the underlying disease, another reason for this high mortality lies in the aggressive ventilatory regimen which is required to maintain arterial blood gases in a more or less normal range. Therapeutic methods which are used to reduce iatrogenic damage to the lungs are pressure controlled ventilation with permissive hypercapnia, differential lung ventilation, positioning therapy, dehydration, and extracorporeal gas exchange with membrane lungs. Nevertheless, many of these patients still die following hypoxaemia or multiple organ failure. Therefore, the need remains to develop new therapeutic strategies and to investigate their influence on the morbidity and mortality of this life-threatening disease. First experiences with nitric oxide (NO) inhalation, intravenous application of antioxidants, intratracheal instillation of surfactant, tracheal gas insufflation and combined fluid/gas ventilation with perfluorocarbon are presented. All these new methods have proved their efficacy, at least in animal studies, however, they should still be regarded as experimental.