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At least 343 records · Page 19Linked to original sources

Hereditary dysautonomias: current knowledge and collaborations for the future.

The hereditary dysautonomias (H-Dys) are a large group of disorders that affect the autonomic nervous system. Research in the field of H-Dys is very challenging, because the disorders involve interdisciplinary, integrative, and "mind-body" connections. Recently, medical scientists, NIH/NINDS representatives, and several patient support groups gathered for the first time in order to discuss recent findings and future directions in the H-Dys field. The H-Dys workshop was instrumental in promoting interactions between basic science and clinical investigators. It also allowed attendees to have an opportunity to meet each other, understand the similarities between the various forms of dysautonomia, and experience the unique perspective offered by patients and their families. Future advances in H-Dys research will depend on a novel multi-system approach by investigators from different medical disciplines, and it is hoped that towards a common goal, novel "bench-to-bedside" therapeutics will be developed to improve the lives of, or even cure, patients suffering from dysautonomic syndromes.

Animals↗

Celiac disease: is the atypical really typical? Summary of the recent National Institutes of Health Consensus Conference and latest advances.

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gluten is a protein component in wheat and other cereals, such as rye and barley. At present, the only available treatment is a strict gluten-free diet. Recent advances have increased our understanding of the molecular basis for this disorder. The past decade has seen new scientific developments in this disease and led to the formulation of new concepts of pathophysiology and clinical manifestations. There are several targets for new treatments. This article briefly summarizes the National Institutes of Health Consensus Statement and gives an overview of new findings in recent years and of future therapeutic options for CD.

Celiac Disease↗

At what levels of total low- or high-density lipoprotein cholesterol should diet/drug therapy be initiated? United States guidelines.

Guidelines for the detection, evaluation and treatment of hypercholesterolemia in adults have been established in the United States. These guidelines recommend that total cholesterol levels be used for screening purposes. Total cholesterol levels greater than 240 mg/dl are considered "high," those from 200 to 239 mg/dl "borderline," and those less than 200 mg/dl "normal," regardless of the person's age or gender. All persons in the high category, as well as those in the borderline category who have other risk factors or established vascular disease, require measurements of low-density lipoprotein (LDL) cholesterol levels. LDL cholesterol levels are used to guide the selection of treatment. Patients with LDL cholesterol levels greater than 130 mg/dl are candidates for active diet therapy. Those whose LDL cholesterol levels are 160 to 190 mg/dl after 3 to 6 months of diet therapy are candidates for drug therapy. A high-density lipoprotein (HDL) level less than 35 mg/dl is considered a risk factor and may influence the level of LDL at which drug therapy is initiated. Some observers have expressed concern that these guidelines overemphasize LDL cholesterol at the expense of total cholesterol, HDL cholesterol and triglyceride levels. Nevertheless, the guidelines have been broadly accepted and currently serve as the basis for a widespread public-health education program.

Cholesterol↗

Overview of current issues in management of dyslipidemia.

An ever-increasing body of evidence supports active intervention in patients with dyslipidemia. Newly formulated recommendations call for evaluation of and treatment decisions based on not only total cholesterol and low-density lipoprotein (LDL) cholesterol levels but also high-density lipoprotein (HDL) cholesterol and triglyceride levels. HDL cholesterol determinations are now encouraged as part of routine coronary risk assessment in healthy adults. In addition, both HDL cholesterol and triglyceride measurements are recommended in patients with coronary artery disease, cardiovascular risk factors, or potentially atherogenic disorders such as hypertension or diabetes. If hygienic measures fail to normalize lipid values, a variety of drugs may be used. Future management strategies may include novel agents that inhibit different steps in lipid metabolism or in cholesterol biosynthesis, drugs that modify the lipoproteins themselves rather than change their concentrations, and drugs that protect the vessel wall from atherogenesis. A problem still to be resolved is that only about 10% of candidates for antihyperlipidemic drug therapy are receiving such treatment.

Cholesterol, HDL↗

Universal screening for infant hearing impairment: simple, beneficial, and presently justified.

In a recent article, Bess and Paradise (Pediatrics 93 (1994) 330-334) rejected the recommendation of the National Institutes of Health that all infants be screened for hearing loss on being released from their birthing hospital. This article responds to their objections with data from the literature and operational newborn hearing screening programs. These data show that universal newborn hearing screening is practicable, effective, cost-efficient, and safe, and concludes that such programs should be implemented without further delay.

Audiometry, Evoked Response↗

A multicenter retrospective review of the mandibular staple bone plate.

The mandibular staple bone plate, herein referred to as the staple, has been used as a reconstructive device to improve mandibular function for more than a decade. This report presents the clinical and radiographic findings of a retrospective survey of 160 patients from three separate practices over an eight-year period (1975-1983). The criteria established at the 1978 NIH-Harvard Consensus Development Conference on Dental Implants were used to evaluate results. The study also evaluates experiences with other procedures used in conjunction with the staple.

Bone Plates↗

Craving: consensus of status and agenda for future research.

The term craving is used frequently in relationship to drug abuse and its treatment but there is disagreement over its definition and role. In February 1991, a meeting of experts from several disciplines, sponsored by the Addiction Research Center (ARC) of the National Institute on Drug Abuse, was convened with the goal of reaching consensus about the importance of craving and to suggest a future research program. The participants agreed that craving is a subjective state in humans that is associated with drug dependence but little is known about its determinants, relationship to drug taking, and measurement. To advance our knowledge, a substantial research program is required. The outcome of this research effort could have important consequences for increasing our understanding of the determinants of drug abuse.

Humans↗

National Institute on Drug Abuse Conference report on placental proteins, drug transport, and fetal development.

The use of illicit and licit drugs during pregnancy is a major public health concern because of potential adverse effects on the fetus and the risk to maternal health. Because the placenta is the primary link between the mother and the conceptus and is essential for the growth and survival of the fetus, abnormalities in placental formation and function resulting from drug use could have a major influence on pregnancy outcome. At present, little information is available on the impact of abused drugs on placental biology alone or in combination with other "host" factors (eg, stress, infections). This prompted the National Institute on Drug Abuse (NIDA) to convene a meeting of experts in placental biology to review cutting-edge research with the mission to translate existing information to new clinical and research initiatives in the drug abuse field. This report summarizes the presentations and research recommendations resulting from the workshop discussions.

Female↗