Hepatitis B virus(HBV)is the leading cause of chronic viral hepatitis.Annually,almost two million children younger than 5 years acquire the infection,mostly through vertical or horizontal transmission in early life.Ve...Hepatitis B virus(HBV)is the leading cause of chronic viral hepatitis.Annually,almost two million children younger than 5 years acquire the infection,mostly through vertical or horizontal transmission in early life.Vertical transmission of HBV is a high efficacy phenomenon ranging,in the absence of any preventive interventions,from 70%to 90%for hepatitis e antigen positive mothers and from 10%to 40%for hepatitis e antigen-negative mothers.Maternal viraemia is a preeminent risk factor for vertical transmission of HBV.Maternal screening is the first step to prevent vertical transmission of HBV.Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection.Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low-and middle-income countries where the prevalence of the infection is at the highest.展开更多
Hepatitis B virus(HBV)infection is one of the main causes of morbidity and mortality worldwide.Most children acquire the infection perinatally or during early childhood and develop a chronic hepatitis characterized by...Hepatitis B virus(HBV)infection is one of the main causes of morbidity and mortality worldwide.Most children acquire the infection perinatally or during early childhood and develop a chronic hepatitis characterized by a high viral replication and a low-inflammation phase of infection,with normal or only slightly raised aminotransferases.Although a conservative approach in children is usually recommended,different therapies exist and different therapeutic approaches are possible.The main goals of antiviral treatment for children with chronic HBV infection are to suppress viral replication and to warn the disease progression to cirrhosis and hepatocellular carcinoma,although these complications are rare in children.Both United States Food and Drug Administration(USFDA)and European Medicines Agency(EMA)have approved interferon alfa-2b for children aged 1 year and older,pegylated interferon alfa-2a and lamivudine for children aged 3 years and older,entecavir for use in children aged 2 years and older,and adefovir for use in those 12 years of age and older.Tenofovir disoproxil fumarate is approved by EMA for children aged 2 years and older and by USFDA for treatment in children aged 12 years and older.Finally,EMA has approved the use of tenofovir alafenamide for treatment of children aged 12 years and older or for children weighing more than 35 kg independent of age.This narrative review will provide the framework for summarizing indications to antiviral therapy in the management of chronic HBV infection in children and adolescents.展开更多
1 Introduction Kounis syndrome constitutes a coronary hypersensitivity disorder defined by the association of an anaphylactoid,anaphylactic,allergic or hypersensitivity reaction with an acute coronary syndrome,in a ph...1 Introduction Kounis syndrome constitutes a coronary hypersensitivity disorder defined by the association of an anaphylactoid,anaphylactic,allergic or hypersensitivity reaction with an acute coronary syndrome,in a physiopathological context involving various interrelated and interacting inflammatory cells,such as mast-cells,eosinophils and platelets.[1,2]Similar entities to Kounis syndrome might involve cerebral and mesenteric arteries.展开更多
Chronic infections by hepatitis B virus(HBV)and hepatitis C virus(HCV)major causes of advanced liver disease and mortality worldwide.Although regarded as benign infections in children,their persistence through adultho...Chronic infections by hepatitis B virus(HBV)and hepatitis C virus(HCV)major causes of advanced liver disease and mortality worldwide.Although regarded as benign infections in children,their persistence through adulthood is undoubtedly of concern.Recent advances in HCV treatment have restored the visibility of these conditions and raised expectations for HBV treatment,which is currently far from being curative.Herein we describe direct-acting antivirals available for pediatric HCV(sofosbuvir/ledipasvir,sofosbuvir/velpatasvir,glecaprevir/pibrentasvir)and their real-world use.A critical review of the HBV pediatric classification is provided.Anti-HBV investigational compounds are reviewed in light of the pathophysiology in the pediatric population,including capsid assembly modulators,antigen secretion inhibitors,silencing RNAs,and immune modifiers.Recommendations for screening and management of immunosuppressed children or those with other risk factors or comorbidities are also summarized.展开更多
Background:Impaired wound healing is one of the most well-known complications of type 2 diabetes mellitus.Experimental evidence suggested that treatment with Exendin-4,a glucagon-like peptide-1 agonist displaying a wi...Background:Impaired wound healing is one of the most well-known complications of type 2 diabetes mellitus.Experimental evidence suggested that treatment with Exendin-4,a glucagon-like peptide-1 agonist displaying a wide range of antidiabetic effects,can promote tissue regeneration.Objectives:Thus,this study aimed to examine the efficacy of topical treatment with Exendin-4 in accelerating wound healing in normoglycemic and hyperglycemic mice.Methods:For this purpose,two wounds inflicted on the back skin of 12 normo-and 12 hyperglycemic mice were injected intradermally with either saline solution or Exendin-4.Wounds were collected at the time of abrasion(T0),48 h(T1),96 h(T2),and 144 h(T3)and cryosections were analyzed by histological and histochemical methods.Results:In wounds treated with Exendin-4,an 85%reduction in size was observed at T3,and the thickness of the epidermis was statistically lower than in untreated wounds.The significative difference was observed in Exendin-4 treated wounds at T2 and T3 in the infiltration of granulocyte populations and at T3 in the degranulation index by mast cells and in the increase in vessels.Fibroblasts were significantly increased in Exendin-4 treated wounds of normo-and hyperglycemic mice at T3,which began to differentiate into myofibroblasts,from T2,and at T3 reached significant values.Conclusion:Taken all together,these results indicate that the topical administration of Exendin-4 had beneficial effects on the acceleration of the healing process of skin wounds in both normo-and hyperglycemic mice.展开更多
文摘Hepatitis B virus(HBV)is the leading cause of chronic viral hepatitis.Annually,almost two million children younger than 5 years acquire the infection,mostly through vertical or horizontal transmission in early life.Vertical transmission of HBV is a high efficacy phenomenon ranging,in the absence of any preventive interventions,from 70%to 90%for hepatitis e antigen positive mothers and from 10%to 40%for hepatitis e antigen-negative mothers.Maternal viraemia is a preeminent risk factor for vertical transmission of HBV.Maternal screening is the first step to prevent vertical transmission of HBV.Hepatitis B passive and active immunoprophylaxis at birth together with antiviral treatment of highly viraemic mothers are the key strategies for global elimination of HBV infection.Strategies are needed to promote implementation of birth-dose vaccination and hepatitis B immunoglobulins in low-and middle-income countries where the prevalence of the infection is at the highest.
文摘Hepatitis B virus(HBV)infection is one of the main causes of morbidity and mortality worldwide.Most children acquire the infection perinatally or during early childhood and develop a chronic hepatitis characterized by a high viral replication and a low-inflammation phase of infection,with normal or only slightly raised aminotransferases.Although a conservative approach in children is usually recommended,different therapies exist and different therapeutic approaches are possible.The main goals of antiviral treatment for children with chronic HBV infection are to suppress viral replication and to warn the disease progression to cirrhosis and hepatocellular carcinoma,although these complications are rare in children.Both United States Food and Drug Administration(USFDA)and European Medicines Agency(EMA)have approved interferon alfa-2b for children aged 1 year and older,pegylated interferon alfa-2a and lamivudine for children aged 3 years and older,entecavir for use in children aged 2 years and older,and adefovir for use in those 12 years of age and older.Tenofovir disoproxil fumarate is approved by EMA for children aged 2 years and older and by USFDA for treatment in children aged 12 years and older.Finally,EMA has approved the use of tenofovir alafenamide for treatment of children aged 12 years and older or for children weighing more than 35 kg independent of age.This narrative review will provide the framework for summarizing indications to antiviral therapy in the management of chronic HBV infection in children and adolescents.
文摘1 Introduction Kounis syndrome constitutes a coronary hypersensitivity disorder defined by the association of an anaphylactoid,anaphylactic,allergic or hypersensitivity reaction with an acute coronary syndrome,in a physiopathological context involving various interrelated and interacting inflammatory cells,such as mast-cells,eosinophils and platelets.[1,2]Similar entities to Kounis syndrome might involve cerebral and mesenteric arteries.
文摘Chronic infections by hepatitis B virus(HBV)and hepatitis C virus(HCV)major causes of advanced liver disease and mortality worldwide.Although regarded as benign infections in children,their persistence through adulthood is undoubtedly of concern.Recent advances in HCV treatment have restored the visibility of these conditions and raised expectations for HBV treatment,which is currently far from being curative.Herein we describe direct-acting antivirals available for pediatric HCV(sofosbuvir/ledipasvir,sofosbuvir/velpatasvir,glecaprevir/pibrentasvir)and their real-world use.A critical review of the HBV pediatric classification is provided.Anti-HBV investigational compounds are reviewed in light of the pathophysiology in the pediatric population,including capsid assembly modulators,antigen secretion inhibitors,silencing RNAs,and immune modifiers.Recommendations for screening and management of immunosuppressed children or those with other risk factors or comorbidities are also summarized.
文摘Background:Impaired wound healing is one of the most well-known complications of type 2 diabetes mellitus.Experimental evidence suggested that treatment with Exendin-4,a glucagon-like peptide-1 agonist displaying a wide range of antidiabetic effects,can promote tissue regeneration.Objectives:Thus,this study aimed to examine the efficacy of topical treatment with Exendin-4 in accelerating wound healing in normoglycemic and hyperglycemic mice.Methods:For this purpose,two wounds inflicted on the back skin of 12 normo-and 12 hyperglycemic mice were injected intradermally with either saline solution or Exendin-4.Wounds were collected at the time of abrasion(T0),48 h(T1),96 h(T2),and 144 h(T3)and cryosections were analyzed by histological and histochemical methods.Results:In wounds treated with Exendin-4,an 85%reduction in size was observed at T3,and the thickness of the epidermis was statistically lower than in untreated wounds.The significative difference was observed in Exendin-4 treated wounds at T2 and T3 in the infiltration of granulocyte populations and at T3 in the degranulation index by mast cells and in the increase in vessels.Fibroblasts were significantly increased in Exendin-4 treated wounds of normo-and hyperglycemic mice at T3,which began to differentiate into myofibroblasts,from T2,and at T3 reached significant values.Conclusion:Taken all together,these results indicate that the topical administration of Exendin-4 had beneficial effects on the acceleration of the healing process of skin wounds in both normo-and hyperglycemic mice.
