Journal of Clinical Medicine

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Open AccessArticle

Long-Term Weight Change after Initiating Second-Generation Antidepressants

by David Arterburn, Tamar Sofer, Denise M. Boudreau, Andy Bogart, Emily O. Westbrook, Mary Kay Theis, Greg Simon and Sebastien Haneuse

J. Clin. Med. 2016, 5(4), 48; https://doi.org/10.3390/jcm5040048 - 13 Apr 2016

Cited by 31 | Viewed by 21787

Abstract

(1) Objective: To examine the relationship between the choice of second-generation antidepressant drug treatment and long-term weight change; (2) Methods: We conducted a retrospective cohort study to investigate the relationship between choice of antidepressant medication and weight change at two years among adult [...] Read more.

(1) Objective: To examine the relationship between the choice of second-generation antidepressant drug treatment and long-term weight change; (2) Methods: We conducted a retrospective cohort study to investigate the relationship between choice of antidepressant medication and weight change at two years among adult patients with a new antidepressant treatment episode between January, 2006 and October, 2009 in a large health system in Washington State. Medication use, encounters, diagnoses, height, and weight were collected from electronic databases. We modeled change in weight and BMI at two years after initiation of treatment using inverse probability weighted linear regression models that adjusted for potential confounders. Fluoxetine was the reference treatment; (3) Results: In intent-to-treat analyses, non-smokers who initiated bupropion treatment on average lost 7.1 lbs compared to fluoxetine users who were non-smokers (95% CI: −11.3, −2.8; p-value < 0.01); smokers who initiated bupropion treatment gained on average 2.2 lbs compared to fluoxetine users who were smokers (95% CI: −2.3, 6.8; p-value = 0.33). Changes in weight associated with all other antidepressant medications were not significantly different than fluoxetine, except for sertraline users, who gained an average of 5.9 lbs compared to fluoxetine users (95% CI: 0.8, 10.9; p-value = 0.02); (4) Conclusion: Antidepressant drug therapy is significantly associated with long-term weight change at two years. Bupropion may be considered as the first-line drug of choice for overweight and obese patients unless there are other existing contraindications. Full article

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Open AccessFeature PaperReview

Management of Status Epilepticus in Children

by Douglas M. Smith, Emily L. McGinnis, Diana J. Walleigh and Nicholas S. Abend

J. Clin. Med. 2016, 5(4), 47; https://doi.org/10.3390/jcm5040047 - 13 Apr 2016

Cited by 35 | Viewed by 23013

Abstract

Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s), as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of [...] Read more.

Status epilepticus is a common pediatric neurological emergency. Management includes prompt administration of appropriately selected anti-seizure medications, identification and treatment of seizure precipitant(s), as well as identification and management of associated systemic complications. This review discusses the definitions, classification, epidemiology and management of status epilepticus and refractory status epilepticus in children. Full article

(This article belongs to the Special Issue Understanding and Treatment of Status Epilepticus)

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Open AccessCase Report

First Time Seizure in the Setting of a Congenital Heart Abnormality and MCA Mycotic Aneurysms

by Michael R. Minckler, Merlin Curry and Jarrod M. Mosier

J. Clin. Med. 2016, 5(4), 46; https://doi.org/10.3390/jcm5040046 - 12 Apr 2016

Cited by 1 | Viewed by 3297

Abstract

A 37 year-old man presented to the Emergency Department (ED) with new onset seizure and fall from standing.[...] Full article

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Open AccessReview

Endothelial to Mesenchymal Transition (EndoMT) in the Pathogenesis of Human Fibrotic Diseases

by Sonsoles Piera-Velazquez, Fabian A. Mendoza and Sergio A. Jimenez

J. Clin. Med. 2016, 5(4), 45; https://doi.org/10.3390/jcm5040045 - 11 Apr 2016

Cited by 211 | Viewed by 14760

Abstract

Fibrotic diseases encompass a wide spectrum of clinical entities including systemic fibrotic diseases such as systemic sclerosis, sclerodermatous graft versus host disease, nephrogenic systemic fibrosis, and IgG₄-associated sclerosing disease, as well as numerous organ-specific disorders including radiation-induced fibrosis, and cardiac, pulmonary, [...] Read more.

Fibrotic diseases encompass a wide spectrum of clinical entities including systemic fibrotic diseases such as systemic sclerosis, sclerodermatous graft versus host disease, nephrogenic systemic fibrosis, and IgG₄-associated sclerosing disease, as well as numerous organ-specific disorders including radiation-induced fibrosis, and cardiac, pulmonary, liver, and kidney fibrosis. Although their causative mechanisms are quite diverse, these diseases share the common feature of an uncontrolled and progressive accumulation of fibrous tissue macromolecules in affected organs leading to their dysfunction and ultimate failure. The pathogenesis of fibrotic diseases is complex and despite extensive investigation has remained elusive. Numerous studies have identified myofibroblasts as the cells responsible for the establishment and progression of the fibrotic process. Tissue myofibroblasts in fibrotic diseases originate from several sources including quiescent tissue fibroblasts, circulating CD34+ fibrocytes, and the phenotypic conversion of various cell types including epithelial and endothelial cells into activated myofibroblasts. However, the role of the phenotypic transition of endothelial cells into mesenchymal cells (Endothelial to Mesenchymal Transition or EndoMT) in the pathogenesis of fibrotic disorders has not been fully elucidated. Here, we review the evidence supporting EndoMT’s contribution to human fibrotic disease pathogenesis. Full article

(This article belongs to the Special Issue Epithelial-Mesenchymal Transition)

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Open AccessReview

Effect of Cigarette Smoking on Epithelial to Mesenchymal Transition (EMT) in Lung Cancer

by Trung Vu, Lin Jin and Pran K. Datta

J. Clin. Med. 2016, 5(4), 44; https://doi.org/10.3390/jcm5040044 - 11 Apr 2016

Cited by 73 | Viewed by 8712

Abstract

Epithelial to mesenchymal transition (EMT) is a process that allows an epithelial cell to acquire a mesenchymal phenotype through multiple biochemical changes resulting in an increased migratory capacity. During cancer progression, EMT is found to be associated with an invasive or metastatic phenotype. [...] Read more.

Epithelial to mesenchymal transition (EMT) is a process that allows an epithelial cell to acquire a mesenchymal phenotype through multiple biochemical changes resulting in an increased migratory capacity. During cancer progression, EMT is found to be associated with an invasive or metastatic phenotype. In this review, we focus on the discussion of recent studies about the regulation of EMT by cigarette smoking. Various groups of active compounds found in cigarette smoke such as polycyclic aromatic hydrocarbons (PAH), nicotine-derived nitrosamine ketone (NNK), and reactive oxygen specicies (ROS) can induce EMT through different signaling pathways. The links between EMT and biological responses to cigarette smoke, such as hypoxia, inflammation, and oxidative damages, are also discussed. The effect of cigarette smoke on EMT is not only limited to cancer types directly related to smoking, such as lung cancer, but has also been found in other types of cancer. Altogether, this review emphasizes the importance of understanding molecular mechanisms of the induction of EMT by cigarette smoking and will help in identifying novel small molecules for targeting EMT induced by smoking. Full article

(This article belongs to the Special Issue Epithelial-Mesenchymal Transition)

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Open AccessReview

EMT Involved in Migration of Stem/Progenitor Cells for Pituitary Development and Regeneration

by Saishu Yoshida, Takako Kato and Yukio Kato

J. Clin. Med. 2016, 5(4), 43; https://doi.org/10.3390/jcm5040043 - 06 Apr 2016

Cited by 27 | Viewed by 7732

Abstract

Epithelial–mesenchymal transition (EMT) and cell migration are important processes in embryonic development of many tissues as well as oncogenesis. The pituitary gland is a master endocrine tissue and recent studies indicate that Sox2-expressing stem/progenitor cells actively migrate and develop this tissue during [...] Read more.

Epithelial–mesenchymal transition (EMT) and cell migration are important processes in embryonic development of many tissues as well as oncogenesis. The pituitary gland is a master endocrine tissue and recent studies indicate that Sox2-expressing stem/progenitor cells actively migrate and develop this tissue during embryogenesis. Notably, although migration activity of stem/progenitor cells in the postnatal period seems to be reduced compared to that in the embryonic period, it is hypothesized that stem/progenitor cells in the adult pituitary re-migrate from their microenvironment niche to contribute to the regeneration system. Therefore, elucidation of EMT in the pituitary stem/progenitor cells will promote understanding of pituitary development and regeneration, as well as diseases such as pituitary adenoma. In this review, so as to gain more insights into the mechanisms of pituitary development and regeneration, we summarize the EMT in the pituitary by focusing on the migration of pituitary stem/progenitor cells during both embryonic and postnatal organogenesis. Full article

(This article belongs to the Special Issue Epithelial-Mesenchymal Transition)

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Open AccessReview

Considering Exosomal miR-21 as a Biomarker for Cancer

by Jian Shi

J. Clin. Med. 2016, 5(4), 42; https://doi.org/10.3390/jcm5040042 - 29 Mar 2016

Cited by 89 | Viewed by 7139

Abstract

Cancer is a fatal human disease. Early diagnosis of cancer is the most effective method to prevent cancer development and to achieve higher survival rates for patients. Many traditional diagnostic methods for cancer are still not sufficient for early, more convenient and accurate, [...] Read more.

Cancer is a fatal human disease. Early diagnosis of cancer is the most effective method to prevent cancer development and to achieve higher survival rates for patients. Many traditional diagnostic methods for cancer are still not sufficient for early, more convenient and accurate, and noninvasive diagnosis. Recently, the use of microRNAs (miRNAs), such as exosomal microRNA-21(miR-21), as potential biomarkers was widely reported. This initial systematic review analyzes the potential role of exosomal miR-21 as a general biomarker for cancers. A total of 10 studies involving 318 patients and 215 healthy controls have covered 10 types of cancers. The sensitivity and specificity of pooled studies were 75% (0.70–0.80) and 85% (0.81–0.91), with their 95% confidence intervals (CIs), while the area under the summary receiver operating characteristic curve (AUC) was 0.93. Additionally, we examined and evaluated almost all other issues about biomarkers, including cutoff points, internal controls and detection methods, from the literature. This initial meta-analysis indicates that exosomal miR-21 has a strong potential to be used as a universal biomarker to identify cancers, although as a general biomarker the case number for each cancer type is small. Based on the literature, a combination of miRNA panels and other cancer antigens, as well as a selection of appropriate internal controls, has the potential to serve as a more sensitive and accurate cancer diagnosis tool. Additional information on miR-21 would further support its use as a biomarker in cancer. Full article

(This article belongs to the Special Issue MicroRNAs: Novel Biomarkers and Therapeutic Targets for Human Cancers)

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Open AccessReview

Signal Transduction Pathways of EMT Induced by TGF-β, SHH, and WNT and Their Crosstalks

by Jingyu Zhang, Xiao-Jun Tian and Jianhua Xing

J. Clin. Med. 2016, 5(4), 41; https://doi.org/10.3390/jcm5040041 - 28 Mar 2016

Cited by 247 | Viewed by 16405

Abstract

Epithelial-to-mesenchymal transition (EMT) is a key step in development, wound healing, and cancer development. It involves cooperation of signaling pathways, such as transformation growth factor-β (TGF-β), Sonic Hedgehog (SHH), and WNT pathways. These signaling pathways crosstalk to each other and converge to key [...] Read more.

Epithelial-to-mesenchymal transition (EMT) is a key step in development, wound healing, and cancer development. It involves cooperation of signaling pathways, such as transformation growth factor-β (TGF-β), Sonic Hedgehog (SHH), and WNT pathways. These signaling pathways crosstalk to each other and converge to key transcription factors (e.g., SNAIL1) to initialize and maintain the process of EMT. The functional roles of multi-signaling pathway crosstalks in EMT are sophisticated and, thus, remain to be explored. In this review, we focused on three major signal transduction pathways that promote or regulate EMT in carcinoma. We discussed the network structures, and provided a brief overview of the current therapy strategies and drug development targeted to these three signal transduction pathways. Finally, we highlighted systems biology approaches that can accelerate the process of deconstructing complex networks and drug discovery. Full article

(This article belongs to the Special Issue Epithelial-Mesenchymal Transition)

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Open AccessReview

Is there A Role for Alpha-Linolenic Acid in the Fetal Programming of Health?

by Alicia I. Leikin-Frenkel

J. Clin. Med. 2016, 5(4), 40; https://doi.org/10.3390/jcm5040040 - 23 Mar 2016

Cited by 11 | Viewed by 8205

Abstract

The role of ω3 alpha linolenic acid (ALA) in the maternal diet during pregnancy and lactation, and its effect on the prevention of disease and programming of health in offspring, is largely unknown. Compared to ALA, ω3 docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids [...] Read more.

The role of ω3 alpha linolenic acid (ALA) in the maternal diet during pregnancy and lactation, and its effect on the prevention of disease and programming of health in offspring, is largely unknown. Compared to ALA, ω3 docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids have been more widely researched due to their direct implication in fetal neural development. In this literature search we found that ALA, the essential ω3 fatty acid and metabolic precursor of DHA and EPA has been, paradoxically, almost unexplored. In light of new and evolving findings, this review proposes that ALA may have an intrinsic role, beyond the role as metabolic parent of DHA and EPA, during fetal development as a regulator of gene programming for the prevention of metabolic disease and promotion of health in offspring. Full article

(This article belongs to the Special Issue Omega-3 Fatty Acids in Health and Disease)

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Open AccessReview

Osteopontin—A Master Regulator of Epithelial-Mesenchymal Transition

by Anai N. Kothari, Matthew L. Arffa, Victor Chang, Robert H. Blackwell, Wing-Kin Syn, Jiwang Zhang, Zhiyong Mi and Paul C. Kuo

J. Clin. Med. 2016, 5(4), 39; https://doi.org/10.3390/jcm5040039 - 23 Mar 2016

Cited by 81 | Viewed by 8504

Abstract

Osteopontin (OPN) plays an important functional role in both physiologic and pathologic states. OPN is implicated in the progression of fibrosis, cancer, and metastatic disease in several organ systems. The epithelial-mesenchymal transition (EMT), first described in embryology, is increasingly being recognized as a [...] Read more.

Osteopontin (OPN) plays an important functional role in both physiologic and pathologic states. OPN is implicated in the progression of fibrosis, cancer, and metastatic disease in several organ systems. The epithelial-mesenchymal transition (EMT), first described in embryology, is increasingly being recognized as a significant contributor to fibrotic phenotypes and tumor progression. Several well-established transcription factors regulate EMT and are conserved across tissue types and organ systems, including TWIST, zinc finger E-box-binding homeobox (ZEB), and SNAIL-family members. Recent literature points to an important relationship between OPN and EMT, implicating OPN as a key regulatory component of EMT programs. In this review, OPN’s interplay with traditional EMT activators, both directly and indirectly, will be discussed. Also, OPN’s ability to restructure the tissue and tumor microenvironment to indirectly modify EMT will be reviewed. Together, these diverse pathways demonstrate that OPN is able to modulate EMT and provide new targets for directing therapeutics. Full article

(This article belongs to the Special Issue Epithelial-Mesenchymal Transition)

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J. Clin. Med., Volume 5, Issue 4 (April 2016) – 10 articles

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