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JCM
Volume 7
Issue 1
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J. Clin. Med., Volume 7, Issue 1 (January 2018) – 10 articles

Cover Story (view full-size image): Irritable bowel syndrome (IBS) is a common condition defined on the basis of presenting symptoms alone. IBS is heterogeneous; it is unlikely that a single factor will explain all instances. Abnormalities in the gut (motility, sensation, immune response, secretion) and brain (abnormal responses to visceral stimuli, co-morbid psychopathology) have been described and led to the development of the paradigm of the gut-brain axis to include the variable contribution of these and other factors in IBS pathogenesis. This axis is now extended to include the gut microbiome—the microbiome-gut-brain axis, based on experiments demonstrating the ability of the microbiome to influence brain function, the demonstration, in IBS, of both a disrupted gut microbiome and clinical benefits from interventions that modify the microbiome. The implications of this novel concept to the assessment and management of IBS are yet to [...] Read more.
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8 pages, 2291 KiB  
Case Report
Clinical Remission of Cutaneous Squamous Cell Carcinoma of the Auricle with Cetuximab and Nivolumab
by Alessandra Chen, Nabilah Ali, Peter Boasberg and Allen S. Ho
J. Clin. Med. 2018, 7(1), 10; https://doi.org/10.3390/jcm7010010 - 10 Jan 2018
Cited by 41 | Viewed by 6377
Abstract
Cutaneous squamous cell carcinomas (SCC) affecting the regions of the head and neck can be challenging to resect surgically and refractory to chemotherapy or radiation therapy. Consequently; the treatment of squamous cell carcinomas of the skin is a focus of current research. One [...] Read more.
Cutaneous squamous cell carcinomas (SCC) affecting the regions of the head and neck can be challenging to resect surgically and refractory to chemotherapy or radiation therapy. Consequently; the treatment of squamous cell carcinomas of the skin is a focus of current research. One such advancement is immunotherapy. Herein we describe clinical remission of invasive, poorly differentiated squamous cell carcinoma of the pre-auricular region with external auditory canal involvement using cetuximab, an epidermal growth factor receptor (EGFR) antibody; and nivolumab, a programmed death receptor-1 (PD-1) antibody. Such durable and comprehensive disease resolution demonstrates the therapeutic potential of cetuximab and nivolumab in surgically challenging, treatment-resistant cutaneous squamous cell carcinoma. Full article
(This article belongs to the Section Dermatology)
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10 pages, 1992 KiB  
Review
The Evolving Treatment of Peripheral Arterial Disease through Guideline-Directed Recommendations
by Ramez Morcos, Boshra Louka, Andrew Tseng, Sanjay Misra, Robert McBane, Heidi Esser and Fadi Shamoun
J. Clin. Med. 2018, 7(1), 9; https://doi.org/10.3390/jcm7010009 - 09 Jan 2018
Cited by 18 | Viewed by 5709
Abstract
Peripheral arterial disease (PAD) refers to partial or complete occlusion of one or more non-coronary arteries that leads to compromised blood flow and ischemia. Numerous processes are involved in arterial stenosis, however, atherosclerosis remains the most common etiology. PAD constitutes a major health [...] Read more.
Peripheral arterial disease (PAD) refers to partial or complete occlusion of one or more non-coronary arteries that leads to compromised blood flow and ischemia. Numerous processes are involved in arterial stenosis, however, atherosclerosis remains the most common etiology. PAD constitutes a major health economic problem, and it is estimated that over 200 million people around the world suffer from PAD, with at least 20% having some degree of claudication. The purpose of this review is to compare and contrast the guidelines on PAD published in 2005, 2011 and 2016 in terms of new recommendations and level of evidence for practicing clinicians. Full article
(This article belongs to the Special Issue Image Guided Interventions and Emerging Technologies)
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4 pages, 157 KiB  
Editorial
Acknowledgement to Reviewers of JCM in 2017
by JCM Editorial Office
J. Clin. Med. 2018, 7(1), 8; https://doi.org/10.3390/jcm7010008 - 09 Jan 2018
Cited by 1 | Viewed by 2418
Abstract
Peer review is an essential part in the publication process, ensuring that JCM maintains high quality standards for its published papers. In 2017, a total of 116 papers were published in the journal.[...] Full article
11 pages, 3323 KiB  
Article
FOLFIRINOX Chemotherapy in Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis of Retrospective and Phase II Studies
by Stephane Thibodeau and Ioannis A. Voutsadakis
J. Clin. Med. 2018, 7(1), 7; https://doi.org/10.3390/jcm7010007 - 04 Jan 2018
Cited by 37 | Viewed by 7306
Abstract
The introduction of the FOLFIRINOX regimen within the last decade marked the first progress in the clinical field of metastatic pancreatic cancer which had not seen any improvements in treatment availability for several years. In a phase III randomized clinical trial, FOLFIRINOX showed [...] Read more.
The introduction of the FOLFIRINOX regimen within the last decade marked the first progress in the clinical field of metastatic pancreatic cancer which had not seen any improvements in treatment availability for several years. In a phase III randomized clinical trial, FOLFIRINOX showed superior efficacy compared to the previous standard treatment of gemcitabine monotherapy. Nevertheless, it is unknown whether the superior results observed in this single phase III clinical trial can be translated more broadly to clinical practice. Our investigation sought to analyze all published evidence of the FOLFIRINOX regimen in series and phase II trials and compare it to the experience of the phase III study. Survival analysis revealed that FOLFIRINOX was associated with an Overall Survival of 10–11 months both in the trials and in off-trial settings, with response rates also similar in both settings. The adverse effect profile was consistent between the pooled phase II and off-trial experience and the FOLFIRINOX regimen arm observed in the randomized phase III trial. Full article
(This article belongs to the Section Oncology)
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8 pages, 1100 KiB  
Review
The Gut-Brain Axis and the Microbiome: Clues to Pathophysiology and Opportunities for Novel Management Strategies in Irritable Bowel Syndrome (IBS)
by Eamonn M.M. Quigley
J. Clin. Med. 2018, 7(1), 6; https://doi.org/10.3390/jcm7010006 - 03 Jan 2018
Cited by 77 | Viewed by 20548
Abstract
Irritable bowel syndrome (IBS) is one of the most common of all medical disorders worldwide and, while for some it represents no more than a nuisance, for others it imposes significant negative impacts on daily life and activities. IBS is a heterogeneous disorder [...] Read more.
Irritable bowel syndrome (IBS) is one of the most common of all medical disorders worldwide and, while for some it represents no more than a nuisance, for others it imposes significant negative impacts on daily life and activities. IBS is a heterogeneous disorder and may well have a number of causes which may lie anywhere from the external environment to the contents of the gut lumen and from the enteric neuromuscular apparatus and the gut immune system to the central nervous system. Consequently, the paradigm of the gut-brain axis, which includes the participation of these various factors, has proven a useful model to assist clinicians and patients alike in understanding the genesis of symptoms in IBS. Now, given the widespread interest in the gut microbiome in health and disease, in general, reports of disordered enteric bacterial communities in IBS, and experimental data to indicate that components of the gut microbiota can influence brain morphology and function, as well as behavior and cognition, this concept has been extended to encompass the microbiota-gut-brain axis. The implications of this novel concept to the assessment and management of IBS will be explored in this review. Full article
(This article belongs to the Special Issue Irritable Bowel Syndrome)
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12 pages, 1190 KiB  
Review
Experimental Models of Irritable Bowel Syndrome and the Role of the Enteric Neurotransmission
by Maria Giuliana Vannucchi and Stefano Evangelista
J. Clin. Med. 2018, 7(1), 4; https://doi.org/10.3390/jcm7010004 - 03 Jan 2018
Cited by 52 | Viewed by 7948
Abstract
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases in humans. It is characterized by visceral pain and/or discomfort, hypersensitivity and abnormal motor responses along with change in gut habits. Although the etio-pathogenesis of IBS is only partially understood, a [...] Read more.
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases in humans. It is characterized by visceral pain and/or discomfort, hypersensitivity and abnormal motor responses along with change in gut habits. Although the etio-pathogenesis of IBS is only partially understood, a main role has been attributed to psychosocial stress of different origin. Animal models such as neonatal maternal separation, water avoidance stress and wrap restraint stress have been developed as psychosocial stressors in the attempt to reproduce the IBS symptomatology and identify the cellular mechanisms responsible for the disease. The study of these models has led to the production of drugs potentially useful for IBS treatment. This review intends to give an overview on the results obtained with the animal models; to emphasize the role of the enteric nervous system in IBS appearance and evolution and as a possible target of drug therapies. Full article
(This article belongs to the Special Issue Irritable Bowel Syndrome)
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7 pages, 205 KiB  
Article
Association of Maternal Factors with Perinatal Complications in Pregnancies Complicated with Diabetes: A Single-Center Retrospective Analysis
by Sho Endo, Yoshifumi Saisho, Kei Miyakoshi, Daigo Ochiai, Tadashi Matsumoto, Yoshinaga Kawano, Masanori Mitsuishi, Junichiro Irie, Masami Tanaka, Shu Meguro, Mamoru Tanaka and Hiroshi Itoh
J. Clin. Med. 2018, 7(1), 5; https://doi.org/10.3390/jcm7010005 - 02 Jan 2018
Cited by 4 | Viewed by 3929
Abstract
Objective: The aim of this study was to clarify the association of maternal factors with perinatal complications in pregnancies complicated with type 1 (T1D) or type 2 diabetes (T2D). Methods: We conducted a retrospective chart review and enrolled 26 Japanese pregnant women with [...] Read more.
Objective: The aim of this study was to clarify the association of maternal factors with perinatal complications in pregnancies complicated with type 1 (T1D) or type 2 diabetes (T2D). Methods: We conducted a retrospective chart review and enrolled 26 Japanese pregnant women with diabetes who received perinatal care at our hospital between 2008 and 2015. Perinatal complications were defined as one or more of the following: miscarriage, fetal death, fetal dysfunction, fetal structural anomaly, small-for-gestational age, large-for-gestational age (LGA), premature birth, neonatal hypoglycemia, pregnancy-induced hypertension (PIH), deterioration of maternal kidney function, and urgent Caesarean section (CS). The associations between perinatal complications and maternal factors were examined. Results: Approximately 70% and 50% of women with T1D and T2D experienced perinatal complications, respectively. LGA, neonatal hypoglycemia, and urgent CS were major perinatal complications in women with T1D, while PIH and urgent CS were major complications in those with T2D. In women with T1D, pre-gestational HbA1c was significantly higher in women with perinatal complications than in those without. In women with T2D, pre-gestational body mass index was significantly higher in women with perinatal complications than in those without. Conclusions: These findings suggest that while pre-gestational glycemic control remains the most important issue in women with T1D, pre-gestational weight control in addition to glycemic control should be greater emphasized in women with T2D to reduce the risk of perinatal complications. Full article
(This article belongs to the Special Issue Therapeutic Strategies for Diabetes in Pregnancy)
10 pages, 200 KiB  
Review
Irritable Bowel Syndrome: Patient-Provider Interaction and Patient Education
by Albena Halpert
J. Clin. Med. 2018, 7(1), 3; https://doi.org/10.3390/jcm7010003 - 02 Jan 2018
Cited by 35 | Viewed by 7071
Abstract
The Patient-Provider (P-P) relationship is the foundation of medical practice. The quality of this relationship is essential, particularly for the management of chronic illness such as Irritable Bowel Syndrome (IBS), since it correlates with disease improvement. A significant aspect of fostering the P-P [...] Read more.
The Patient-Provider (P-P) relationship is the foundation of medical practice. The quality of this relationship is essential, particularly for the management of chronic illness such as Irritable Bowel Syndrome (IBS), since it correlates with disease improvement. A significant aspect of fostering the P-P relationship is providing effective patient-centered education about IBS. An effective education empowers the patients to achieve the main therapeutic goals: to reduce symptoms and improve quality of life. Method: A literature search of PubMed was conducted using the terms “Irritable Bowel syndrome”, “Patient Physician Relationship”, “Patient Provider Relationship”, and “Patient Physician interaction”. Preference was given to articles with a clearly defined methodology and those with control groups if applicable/appropriate. This article provides a review of the literature on Patient-Provider interaction and patient education as it relates to IBS and provides practical recommendations on how to optimize this important relationship. Full article
(This article belongs to the Special Issue Irritable Bowel Syndrome)
187 KiB  
Case Report
Prevalence of Idiopathic Cyclic Edema in Women with Lower Limb Lymphedema
by Jose Maria Pereira de Godoy, Henrique Jose Pereira de Godoy, Lívia Maria Pereira de Godoy and Maria De Fatima Guerreiro Godoy
J. Clin. Med. 2018, 7(1), 2; https://doi.org/10.3390/jcm7010002 - 25 Dec 2017
Cited by 14 | Viewed by 4030
Abstract
Cyclic edema is a clinical condition in women that leads to fluid retention in the orthostatic position. The aim of the present study was to evaluate the prevalence of idiopathic cyclic edema in women with lower limb lymphedema. The prevalence of idiopathic cyclic [...] Read more.
Cyclic edema is a clinical condition in women that leads to fluid retention in the orthostatic position. The aim of the present study was to evaluate the prevalence of idiopathic cyclic edema in women with lower limb lymphedema. The prevalence of idiopathic cyclic edema was evaluated in a retrospective study of 100 consecutive female patients submitted to leg lymphedema treatment at the Clínica Godoy. The diagnosis of lymphedema was clinical, based on patient history and a physical examination. Patients with clinical stage II lymphedema were included in the study with those in stages I and III being excluded. The diagnosis of idiopathic cyclic edema was based on the patient’s history and fluid retention of more than one kilogram between 7:00 a.m. and 5:00 p.m. Clinical signs of this disease include difficulty removing rings in the morning that becomes easier during the course of the day, waking up with a swollen face, and abdominal discomfort during the day. After diagnosing cyclic edema, a therapeutic test was performed using aminaphtone or calcium dobesilate with which fluid retention was reduced to less than 300 g during the same period. The patients were instructed to drink liquids only when they were thirsty. Full article
285 KiB  
Review
Epithelial Mesenchymal Transition in Embryonic Development, Tissue Repair and Cancer: A Comprehensive Overview
by Do Hyung Kim, Tiaosi Xing, Zhibin Yang, Ronald Dudek, Qun Lu and Yan-Hua Chen
J. Clin. Med. 2018, 7(1), 1; https://doi.org/10.3390/jcm7010001 - 22 Dec 2017
Cited by 191 | Viewed by 8590
Abstract
The epithelial mesenchymal transition (EMT) plays a central role in both normal physiological events (e.g., embryonic development) and abnormal pathological events (e.g., tumor formation and metastasis). The processes that occur in embryonic development are often reactivated under pathological conditions such as oncogenesis. Therefore, [...] Read more.
The epithelial mesenchymal transition (EMT) plays a central role in both normal physiological events (e.g., embryonic development) and abnormal pathological events (e.g., tumor formation and metastasis). The processes that occur in embryonic development are often reactivated under pathological conditions such as oncogenesis. Therefore, defining the regulatory networks (both gene and protein levels) involved in the EMT during embryonic development will be fundamental in understanding the regulatory networks involved in tumor development, as well as metastasis. There are many molecules, factors, mediators and signaling pathways that are involved in the EMT process. Although the EMT is a very old topic with numerous publications, recent new technologies and discoveries give this research area some new perspective and direction. It is now clear that these important processes are controlled by a network of transcriptional and translational regulators in addition to post-transcriptional and post-translational modifications that amplify the initial signals. In this review article, we will discuss some key concepts, historical findings, as well as some recent progresses in the EMT research field. Full article
(This article belongs to the Special Issue Epithelial-Mesenchymal Transition)
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