To screen or not to screen: How to find and identify very early arthritis

There is accumulating evidence demonstrating that early treatment leads to better outcomes in rheumatoid arthritis. In order to be treated early, patients thus need to be identified at the earliest possible stage. This means identifying patients with rheumatoid arthritis at their earliest clinical signs but it could also mean screening for healthy individuals at high risk of developing rheumatoid arthritis. The different tools available to screen for these individuals are reviewed here and their relevance is discussed.     

Pharmacology of anticoagulants used in the treatment of venous thromboembolism

Anticoagulant drugs are the foundation of therapy for patients with VTE. While effective therapeutic agents, anticoagulants can also result in hemorrhage and other side effects. Thus, anticoagulant therapy selection should be guided by the risks, benefits and pharmacologic characteristics of each agent for each patient. Safe use of anticoagulants requires not only an in-depth knowledge of their pharmacologic properties but also a comprehensive approach to patient management and education. This paper will summarize the key pharmacologic properties of the anticoagulant agents used in the treatment of patients with VTE.     

Association of Maternal Obesity and Childhood Obesity: Implications for Healthcare Providers

The purpose of this critical appraisal was to assess the available literature on the association of maternal obesity as a risk factor for childhood obesity and to explore the implications for incorporating this evidence into practice. The increasing prevalence of childhood obesity, with its documented adverse health effects, is a critical public health threat in the United States and worldwide. Research studies have documented increased rates of childhood obesity associated with maternal obesity. Healthcare providers are challenged to expand their competencies to recognize the association of maternal obesity and childhood obesity and to address both primary and secondary prevention of childhood obesity. Stopping the cycle of obesity before it becomes the leading cause of preventable disease and death in the United States is a priority for community health nurses.     

Lung cancer: What are the links with oxidative stress,physical activity and nutrition

Oxidative stress appears to play an essential role as a secondary messenger in the normal regulation of a variety of physiological processes, such as apoptosis, survival, and proliferative signaling pathways. Oxidative stress also plays important roles in the pathogenesis of many diseases, including aging, degenerative disease, and cancer. Among cancers, lung cancer is the leading cause of cancer in the Western world. Lung cancer is the commonest fatal cancer whose risk is dependent on the number of cigarettes smoked per day as well as the number of years smoking, some components of cigarette smoke inducing oxidative stress by transmitting or generating oxidative stress. It can be subdivided into two broad categories, small cell lung cancer and non-small-cell lung cancer, the latter is the most common type. Distinct measures of primary and secondary prevention have been investigated to reduce the risk of morbidity and mortality caused by lung cancer. Among them, it seems that physical activity and nutrition have some beneficial effects. However, physical activity can have different influences on carcinogenesis, depending on energy supply, strength and frequency of exercise loads as well as the degree of exercise-mediated oxidative stress. Micronutrient supplementation seems to have a positive impact in lung surgery, particularly as an antioxidant, even if the role of micronutrients in lung cancer remains controversial. The purpose of this review is to examine lung cancer in relation to oxidative stress, physical activity, and nutrition.