Hallazgos de angiografía por tomografía computarizada de la mediólisis arterial segmentaria

ObjectiveTo review the principal findings on computed tomography angiography for segmental arterial mediolysis, and to emphasize the points that help to differentiate it from other vasculopathies such as vasculitis. We also review the protocols for follow-up and the various treatment options.ConclusionSegmental arterial mediolysis is a rare disease that is defined as a non-atherosclerotic, non-hereditary, and non-inflammatory vasculopathy characterized by lysis of the medial layer of the arterial wall. It should be suspected in middle-aged patients with aneurysms, dissections, or spontaneous ruptures of visceral arteries of unknown etiology who do not fulfill the clinical and laboratory criteria for vasculitis. The arteries of the abdominal organs are the most commonly affected, including the arteries of the celiac trunk and the superior and inferior mesenteric arteries. Radiologically, segmental arterial mediolysis can present as arterial dilation; single or multiple, saccular or fusiform aneurysms; stenoses; or dissections.     

Correlates of HPV Knowledge in the Era of HPV Vaccination: A Study of Unvaccinated Young Adult Women

Until recently, awareness of the sexually transmitted infection human papillomavirus—the virus that causes cervical cancer—was relatively low. The purpose of this study was to identify factors associated with human papillomavirus knowledge now that human papillomavirus vaccines have become widely available. Young adult women (n = 739; aged 18–26 years) attending Florida State University who had not yet initiated human papillomavirus vaccination completed a survey between March–August 2009. The survey assessed human papillomavirus awareness, human papillomavirus knowledge, demographics, socio-political variables, sexual history, and health history variables. Over 97% of participants were aware of human papillomavirus prior to study enrollment; however, knowledge of human papillomavirus was only moderate. A multivariate regression analysis examining factors related to human papillomavirus knowledge revealed five independent correlates: Latina ethnicity, premarital sex values, number of lifetime sexual partners, history of cervical dysplasia, and HIV testing. These variables accounted for 14% of the variance in human papillomavirus knowledge. Less knowledge was observed for Latinas and women opposed to premarital sex. Greater knowledge was observed for women who had been tested for HIV and women with more sexual partners or a history of cervical dysplasia. These findings can inform future human papillomavirus vaccination campaigns and may be particularly useful in developing interventions for individuals with the largest deficits in human papillomavirus knowledge.     

Recent initiatives and strategies to developing new drugs for tropical parasitic diseases

Background: Despite the toll of tropical parasitic diseases on human life in the developing world, present therapies still rely on drugs developed decades ago. In many cases, the clinical usefulness of these compounds is limited due to poor efficacy, toxicity and the constant attrition of drug resistance. The absence of a profit incentive regarding diseases afflicting the very poor has resulted in a lack of investment by the pharmaceutical industry in new chemotherapies. Objective: Given this background, this review addresses what alternative economic and scientific strategies have been implemented to procure novel drugs. Methods: The latest chemical, genetic and screening technologies to discover and develop drugs for tropical parasitic diseases are reviewed. In many cases these strategies are being implemented within the framework of public-private partnerships established to sustain dynamic drug development portfolios. Examples of public-private partnerships and their portfolios are discussed. Further, the contribution of dedicated academic screening centres to target discovery and preclinical prosecution of new small molecules is also highlighted. In every case, the latest scientific literature is cited, but also relevant press releases and website information to indicate the present vitality in the field. Conclusion: The tools, institutions and consortia are now in place and evolving to deliver new pharmaceuticals. Short-term results have already been realised in the clinic, mainly through the provision of new formulations of existing drugs. Long-term and consistent investment will be required, however, to identify, develop and clinically validate new chemical entities.     

Liver X receptor modulators: a review of recently patented compounds (2009 – 2012)

Introduction: The development of small molecule agonists of the liver X receptors (LXRs) has been an area of interest for over a decade, given the critical role of those receptors in cholesterol metabolism, glucose homeostasis, inflammation, innate immunity and lipogenesis. Many potential indications have been characterized over time including atherosclerosis, diabetes, inflammation, Alzheimer's disease and cancer. However, concerns about the lipogenic effects of full LXRα/β agonists have required extensive efforts aimed at identifying LXRβ agonist with limited activity on the LXRα receptor to increase the safety margins.

Areas covered: This review includes a summary of the LXR agonists that have reached the clinic and summarizes the patent applications for LXR modulators from September 2009 to December 2012 with emphasis on chemical matters, biological data associated with selected analogs and therapeutic indications.

Expert opinion: As LXR agonists have the potential to be useful for many indications, the scientific community, despite setbacks due to on-target side effects, has maintained interest and devised strategies to overcome safety hurdles. While a clinical proof of concept still remains elusive, the recent advancement of compounds into the clinic highlights that acceptable safety margins in preclinical species have been achieved.     

Exercise in neuromuscular disease

In this review, we present an overview of the role of exercise in neuromuscular disease (NMD). We demonstrate that despite the different pathologies in NMDs, exercise is beneficial, whether aerobic/endurance or strength/resistive training, and we explore whether this benefit has a similar mechanism to that of healthy subjects. We discuss further areas for study, incorporating imaginative and novel approaches to training and its assessment in NMD. We conclude by suggesting ways to improve future trials by avoiding previous methodological flaws and drawbacks in this field. Muscle Nerve, 2013