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  1. Article ; Online: Variation in salivary cortisol responses in yearling Thoroughbred racehorses during their first year of training.

    Holtby, Amy R / McGivney, Beatrice A / Browne, John A / Katz, Lisa M / Murphy, Keith J / Hill, Emmeline W

    PloS one

    2023  Volume 18, Issue 4, Page(s) e0284102

    Abstract: Thoroughbred horses are bred for competitive racing and undergo intense training regimes. The maintenance of physical soundness and desirable behavioural characteristics are critical to the longevity of a racing career. Horses intended for Flat racing ... ...

    Abstract Thoroughbred horses are bred for competitive racing and undergo intense training regimes. The maintenance of physical soundness and desirable behavioural characteristics are critical to the longevity of a racing career. Horses intended for Flat racing generally enter training as yearlings and undergo introductory training prior to exercise conditioning for racing. This period requires rapid adjustment to a novel environment. As a prey animal, a horse's 'fight-or-flight' response is highly adapted, in which a well-understood component of this response, the hypothalamic-pituitary-axis, is activated in response to a stress stimulus, releasing cortisol. In the Thoroughbred, a significant difference in salivary cortisol concentrations between pre- and post-first time ridden (i.e., first backing) by a jockey have previously been identified. Here, to test the hypothesis that salivary cortisol concentrations may be used to objectively detect individual variations in the acute physiological stress response we investigate individual variation in cortisol response to training milestones. Saliva samples were collected from a cohort of n = 96 yearling Flat racehorses, at the same training yard, across three timepoints at rest: before entering the training yard (n = 66), within three days of entry to the training yard (n = 67) and following 2-3 weeks in the training yard (n = 50). Salivary cortisol concentration was measured using an ELISA. There was no significant difference in cortisol concentration (ANOVA, P > 0.05) across the samples collected at timepoints at rest. Samples were also collected before and 30 minutes after exposure to three novel training events: first time long-reined (n = 6), first time backed by a jockey (n = 34), and first time ridden on the gallops (n = 10). Mean salivary cortisol concentration after all three novel training events was significantly higher than prior to the training event (Paired t-test, P <0.005). The ranges of post-event salivary cortisol concentration across all timepoints suggest individual variation in the measured stress response, reflecting individual differences in stress response to the early training environment. This measure may be used as an objective assessment of the stress response of Thoroughbred racehorses during training.
    MeSH term(s) Horses ; Animals ; Hydrocortisone ; Physical Conditioning, Animal ; Horse Diseases ; Running ; Physical Examination
    Chemical Substances Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2023-04-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0284102
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Integrative genomics analysis highlights functionally relevant genes for equine behaviour

    Holtby, Amy R. / Hall, Thomas J. / McGivney, Beatrice A. / Han, Haige / Murphy, Keith J. / MacHugh, David E. / Katz, Lisa M. / Hill, Emmeline W.

    Animal Genetics. 2023 Aug., v. 54, no. 4 p.457-469

    2023  

    Abstract: Behavioural plasticity enables horses entering an exercise training programme to adapt with reduced stress. We characterised SNPs associated with behaviour in yearling Thoroughbred horses using genomics analyses for two phenotypes: (1) handler‐assessed ... ...

    Abstract Behavioural plasticity enables horses entering an exercise training programme to adapt with reduced stress. We characterised SNPs associated with behaviour in yearling Thoroughbred horses using genomics analyses for two phenotypes: (1) handler‐assessed coping with early training events [coping] (n = 96); and (2) variation in salivary cortisol concentration at the first backing event [cortisol] (n = 34). Using RNA‐seq derived gene expression data for amygdala and hippocampus tissues from n = 2 Thoroughbred stallions, we refined the SNPs to those with functional relevance to behaviour by cross‐referencing to the 500 most highly expressed genes in each tissue. The SNPs of high significance (q < 0.01) were in proximity to genes (coping – GABARAP, NDM, OAZ1, RPS15A, SPARCL1, VAMP2; cortisol – CEBPA, COA3, DUSP1, HNRNPH1, RACK1) with biological functions in social behaviour, autism spectrum disorder, suicide, stress‐induced anxiety and depression, Alzheimer's disease, neurodevelopmental disorders, neuroinflammatory disease, fear‐induced behaviours and alcohol and cocaine addiction. The strongest association (q = 0.0002) was with NDN, a gene previously associated with temperament in cattle. This approach highlights functionally relevant genes in the behavioural adaptation of Thoroughbred horses that will contribute to the development of genetic markers to improve racehorse welfare.
    Keywords Alzheimer disease ; Thoroughbred ; alcohols ; amygdala ; animal genetics ; anxiety ; autism ; cattle ; cocaine ; cortisol ; exercise ; gene expression ; genes ; genomics ; hippocampus ; racehorses ; sequence analysis ; social behavior ; suicide ; temperament ; yearlings
    Language English
    Dates of publication 2023-08
    Size p. 457-469.
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note JOURNAL ARTICLE
    ZDB-ID 632766-7
    ISSN 1365-2052 ; 0268-9146 ; 0268-9154
    ISSN (online) 1365-2052
    ISSN 0268-9146 ; 0268-9154
    DOI 10.1111/age.13320
    Database NAL-Catalogue (AGRICOLA)

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  3. Article ; Online: Integrative genomics analysis highlights functionally relevant genes for equine behaviour.

    Holtby, Amy R / Hall, Thomas J / McGivney, Beatrice A / Han, Haige / Murphy, Keith J / MacHugh, David E / Katz, Lisa M / Hill, Emmeline W

    Animal genetics

    2023  Volume 54, Issue 4, Page(s) 457–469

    Abstract: Behavioural plasticity enables horses entering an exercise training programme to adapt with reduced stress. We characterised SNPs associated with behaviour in yearling Thoroughbred horses using genomics analyses for two phenotypes: (1) handler-assessed ... ...

    Abstract Behavioural plasticity enables horses entering an exercise training programme to adapt with reduced stress. We characterised SNPs associated with behaviour in yearling Thoroughbred horses using genomics analyses for two phenotypes: (1) handler-assessed coping with early training events [coping] (n = 96); and (2) variation in salivary cortisol concentration at the first backing event [cortisol] (n = 34). Using RNA-seq derived gene expression data for amygdala and hippocampus tissues from n = 2 Thoroughbred stallions, we refined the SNPs to those with functional relevance to behaviour by cross-referencing to the 500 most highly expressed genes in each tissue. The SNPs of high significance (q < 0.01) were in proximity to genes (coping - GABARAP, NDM, OAZ1, RPS15A, SPARCL1, VAMP2; cortisol - CEBPA, COA3, DUSP1, HNRNPH1, RACK1) with biological functions in social behaviour, autism spectrum disorder, suicide, stress-induced anxiety and depression, Alzheimer's disease, neurodevelopmental disorders, neuroinflammatory disease, fear-induced behaviours and alcohol and cocaine addiction. The strongest association (q = 0.0002) was with NDN, a gene previously associated with temperament in cattle. This approach highlights functionally relevant genes in the behavioural adaptation of Thoroughbred horses that will contribute to the development of genetic markers to improve racehorse welfare.
    MeSH term(s) Horses/genetics ; Animals ; Male ; Cattle ; Hydrocortisone ; Autism Spectrum Disorder ; Genomics ; Phenotype
    Chemical Substances Hydrocortisone (WI4X0X7BPJ)
    Language English
    Publishing date 2023-03-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 632766-7
    ISSN 1365-2052 ; 0268-9146 ; 0268-9154
    ISSN (online) 1365-2052
    ISSN 0268-9146 ; 0268-9154
    DOI 10.1111/age.13320
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Neuron-glia crosstalk in health and disease: fractalkine and CX3CR1 take centre stage.

    Sheridan, Graham K / Murphy, Keith J

    Open biology

    2013  Volume 3, Issue 12, Page(s) 130181

    Abstract: An essential aspect of normal brain function is the bidirectional interaction and communication between neurons and neighbouring glial cells. To this end, the brain has evolved ligand-receptor partnerships that facilitate crosstalk between different cell ...

    Abstract An essential aspect of normal brain function is the bidirectional interaction and communication between neurons and neighbouring glial cells. To this end, the brain has evolved ligand-receptor partnerships that facilitate crosstalk between different cell types. The chemokine, fractalkine (FKN), is expressed on neuronal cells, and its receptor, CX(3)CR1, is predominantly expressed on microglia. This review focuses on several important functional roles for FKN/CX(3)CR1 in both health and disease of the central nervous system. It has been posited that FKN is involved in microglial infiltration of the brain during development. Microglia, in turn, are implicated in the developmental synaptic pruning that occurs during brain maturation. The abundance of FKN on mature hippocampal neurons suggests a homeostatic non-inflammatory role in mechanisms of learning and memory. There is substantial evidence describing a role for FKN in hippocampal synaptic plasticity. FKN, on the one hand, appears to prevent excess microglial activation in the absence of injury while promoting activation of microglia and astrocytes during inflammatory episodes. Thus, FKN appears to be neuroprotective in some settings, whereas it contributes to neuronal damage in others. Many progressive neuroinflammatory disorders that are associated with increased microglial activation, such as Alzheimer's disease, show disruption of the FKN/CX(3)CR1 communication system. Thus, targeting CX(3)CR1 receptor hyperactivation with specific antagonists in such neuroinflammatory conditions may eventually lead to novel neurotherapeutics.
    MeSH term(s) Animals ; Brain/physiology ; Brain/physiopathology ; CX3C Chemokine Receptor 1 ; Central Nervous System Diseases/physiopathology ; Chemokine CX3CL1/physiology ; Humans ; Inflammation/physiopathology ; Learning/physiology ; Neuroglia/physiology ; Neuronal Plasticity ; Neurons/physiology ; Receptors, Cytokine/physiology ; Receptors, HIV/physiology
    Chemical Substances CX3C Chemokine Receptor 1 ; Chemokine CX3CL1 ; Receptors, Cytokine ; Receptors, HIV
    Language English
    Publishing date 2013-12-18
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2630944-0
    ISSN 2046-2441 ; 2046-2441
    ISSN (online) 2046-2441
    ISSN 2046-2441
    DOI 10.1098/rsob.130181
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: A pre-operative platelet transfusion algorithm for patients with cirrhosis and hepatocellular carcinoma undergoing laparoscopic microwave ablation.

    Baimas-George, Maria / Watson, Michael / Salibi, Patrick / Murphy, Keith J / Vrochides, Dionisios / Martinie, John B / Baker, Erin H / Iannitti, David A

    Surgical endoscopy

    2020  Volume 35, Issue 7, Page(s) 3811–3817

    Abstract: Background: Thrombocytopenia is a common finding in patients with chronic liver disease. It is associated with poor clinical outcomes due to increased risk of bleeding after even minor procedures. We sought to determine an algorithm for pre-operative ... ...

    Abstract Background: Thrombocytopenia is a common finding in patients with chronic liver disease. It is associated with poor clinical outcomes due to increased risk of bleeding after even minor procedures. We sought to determine an algorithm for pre-operative platelet transfusion in patients with cirrhosis and hepatocellular carcinoma (HCC) undergoing laparoscopic microwave ablation (MIS-MWA).
    Methods: A retrospective review identified all patients with cirrhosis and HCC who underwent MIS-MWA at a single tertiary institution between 2007 and 2019. Demographics, pre-operative and post-operative laboratory values, transfusion requirements, and bleeding events were collected. The analyzed outcome of bleeding risk included any transfusion received intra-operatively or a transfusion or surgical intervention post-operatively. Logistic regression models were created to predict bleeding risk and identify patients who would benefit from pre-operative transfusion.
    Results: There were 433 patients with cirrhosis and HCC who underwent MIS-MWA identified; of these, 353 patients had complete laboratory values and were included. Bleeding risk was evaluated through bivariate analysis of statistically and clinically significant variables. The accuracy of both models was substantiated through bootstrap validation for 500 iterations (model 1: ROC 0.8684, Brier score 0.0238; model 2: ROC 0.8363, Brier score 0.0252). The first model captured patients with both thrombocytopenia and anemia: platelet count < 60 × 10
    Conclusion: The prediction of patients with cirrhosis and HCC requiring pre-operative platelet transfusions may help to avoid bleeding complications after invasive procedures. This study needs to be prospectively validated and ultimately may be beneficial in assessment of novel therapies for platelet-based clinical treatment in liver disease.
    MeSH term(s) Algorithms ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/surgery ; Humans ; Laparoscopy ; Liver Cirrhosis/complications ; Liver Cirrhosis/surgery ; Liver Neoplasms/complications ; Liver Neoplasms/surgery ; Microwaves ; Platelet Transfusion ; Retrospective Studies
    Language English
    Publishing date 2020-07-06
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-020-07760-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Robotic pancreaticoduodenectomy may offer improved oncologic outcomes over open surgery: a propensity-matched single-institution study.

    Baimas-George, Maria / Watson, Michael / Murphy, Keith J / Iannitti, David / Baker, Erin / Ocuin, Lee / Vrochides, Dionisios / Martinie, John B

    Surgical endoscopy

    2020  Volume 34, Issue 8, Page(s) 3644–3649

    Abstract: Background: The robotic platform in pancreatic disease has gained popularity in the hepatobiliary community due to significant advantages it technically offers over conventional open and laparoscopic techniques. Despite promising initial studies, there ... ...

    Abstract Background: The robotic platform in pancreatic disease has gained popularity in the hepatobiliary community due to significant advantages it technically offers over conventional open and laparoscopic techniques. Despite promising initial studies, there remains scant literature on operative and oncologic outcomes of robotic pancreaticoduodenectomy (RPD) for pancreatic adenocarcinoma.
    Methods: A retrospective review evaluated all RPD performed for pancreatic adenocarcinoma from 2008 to 2019 in a single tertiary institution. RPD cases were matched to open cases (OPD) by demographic and oncologic characteristics and outcomes compared using Mann-Whitney U test, log rank tests, and Kaplan-Meier methods.
    Results: Thirty-eight RPD cases were matched to 38 OPD. RPD had significantly higher lymph node (LN) yield (21.5 vs 13.5; p = 0.0036) and no difference in operative time or estimated blood loss (EBL). RPD had significantly lower rate of delayed gastric emptying (DGE) (3% vs 32%; p = 0.0009) but no difference in leaks, infections, hemorrhage, urinary retention ,or ileus. RPD had significantly shorter length of stay (LOS) (7.5 vs. 9; p = 0.0209). There were no differences in 30- or 90-day readmissions or 90-day mortality. There was an equivalent R0 resection rate and LN positivity ratio. There was a trend towards improved median overall survival in RPD (30.4 vs. 23.0 months; p = 0.1105) and longer time to recurrence (402 vs. 284 days; p = 0.7471). OPD had two times the local recurrent rate (16% vs. 8%) but no difference in distant recurrence.
    Conclusions: While the feasibility and safety of RPD has been demonstrated, the impact on oncologic outcomes had yet to be investigated. We demonstrate that RPD not only offers similar if not superior immediate post-operative benefit by decreasing DGE but more importantly may offer improved oncologic outcomes. The significantly higher LN yield and decreased inflammatory response demonstrated in robotic surgery may improve overall survival.
    MeSH term(s) Adenocarcinoma/mortality ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy/methods ; Retrospective Studies ; Robotic Surgical Procedures/methods
    Language English
    Publishing date 2020-04-23
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-020-07564-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Vertical Compliance: A novel method of reporting patient specific ERAS compliance for real-time risk assessment.

    Baimas-George, Maria / Cochran, Allyson / Watson, Michael / Murphy, Keith J / Iannitti, David / Martinie, John B / Baker, Erin / Ocuin, Lee / Vrochides, Dionisios

    International journal of medical informatics

    2020  Volume 141, Page(s) 104194

    Abstract: Background: ERAS protocol compliance is traditionally measured and reported as 'items compliance' which is retrospective longitudinal adherence of all patients to an index element. Reporting in this manner is restrictive and cannot impact care in real- ... ...

    Abstract Background: ERAS protocol compliance is traditionally measured and reported as 'items compliance' which is retrospective longitudinal adherence of all patients to an index element. Reporting in this manner is restrictive and cannot impact care in real-time. In order to modify behavior effectively and instantaneously, we seek to introduce the novel concept of "vertical compliance".
    Methods: Vertical compliance is defined as assessment of an individual's compliance along his/her own surgical pathway as ERAS index items are encountered. Prospectively entered data from the ERAS Interactive Audit System (EIAS) database was queried for all patients who underwent pancreatic or hepatic resections. Individual linear regression models were generated using compliance data from 46 ERAS index items against LOS. Significant items with p value < 0.05 were compiled into multivariable linear regression models; each with a unique coefficient that could be used to predict effect on LOS as well as control for the effect of the other items in the model.
    Results: Compliance data from 483 patients who underwent pancreatic resections and 292 patients who underwent hepatic resections was compiled. Seven ERAS items for pancreatic resections and six ERAS items for hepatic resections were found to significantly impact LOS. Regression models were created for each of the items in an additive fashion. Calculations to determine predicted LOS as a patient progressed through a pathway was able to be determined.
    Conclusion: Vertical compliance is a novel metric, described in this study, that can provide significant and accurate patient-specific risk prediction to impact care in real-time. This can allow for creation of a variable echelon such that pathway items can be ranked by importance on clinical outcome effect and patient progress can be monitored and altered.
    MeSH term(s) Female ; Guideline Adherence ; Humans ; Length of Stay ; Male ; Patient Compliance ; Postoperative Complications ; Recovery of Function ; Retrospective Studies ; Risk Assessment
    Language English
    Publishing date 2020-05-27
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 1466296-6
    ISSN 1872-8243 ; 1386-5056
    ISSN (online) 1872-8243
    ISSN 1386-5056
    DOI 10.1016/j.ijmedinf.2020.104194
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Novel use of REDCap to develop an advanced platform to display predictive analytics and track compliance with Enhanced Recovery After Surgery for pancreaticoduodenectomy.

    Cochran, Allyson R / Raub, Kyle M / Murphy, Keith J / Iannitti, David A / Vrochides, Dionisios

    International journal of medical informatics

    2018  Volume 119, Page(s) 54–60

    Abstract: Background: Prediction models are increasingly being used with clinical practice guidelines to inform decision making. Enhanced Recovery After Surgery (ERAS: Methods: Predictive models were developed from retrospective data on 400 patients who ... ...

    Abstract Background: Prediction models are increasingly being used with clinical practice guidelines to inform decision making. Enhanced Recovery After Surgery (ERAS
    Methods: Predictive models were developed from retrospective data on 400 patients who underwent pancreaticoduodenectomy from 2008 through 2014. The REDCap was programmed to display predictive analytics and create a data tracking system that met ERAS guidelines. Based on predictive scores for serious complication, 30-day readmission, and 30-day mortality, we developed targeted interventions to decrease readmissions and postoperative laboratory tests.
    Results: Predictive models demonstrated a receiver-operating characteristic area (ROC) ranges of 641-856. After implementing the REDCap platform, the readmission rate for high-risk patients decreased 15.8% during the initial three months following ERAS implementation. Based on predictive outputs, patients with a low-risk score received a limited set of postoperative laboratory tests. Targeted interventions to decrease hospital readmission for high-risk patients included home care orders and post-discharge instructions.
    Conclusions: The REDCap platform offers hospitals a practical option to display predictive analytics and create a data tracking program that meets ERAS guidelines. Prediction models programmed into REDCap offer clinicians a support tool to assess the probability of patient outcomes. Risk calculations based on predictive scores enabled clinicians to titrate postoperative laboratory tests and develop post-discharge home care orders.
    MeSH term(s) Aged ; Aged, 80 and over ; Data Collection/methods ; Electronic Health Records ; Female ; Humans ; Length of Stay ; Male ; Pancreatic Diseases/surgery ; Pancreaticoduodenectomy/rehabilitation ; Patient Compliance/statistics & numerical data ; Patient Discharge/statistics & numerical data ; Patient Readmission/statistics & numerical data ; Postoperative Complications/diagnosis ; Postoperative Complications/prevention & control ; Predictive Value of Tests ; Recovery of Function ; Retrospective Studies
    Language English
    Publishing date 2018-09-06
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 1466296-6
    ISSN 1872-8243 ; 1386-5056
    ISSN (online) 1872-8243
    ISSN 1386-5056
    DOI 10.1016/j.ijmedinf.2018.09.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Robotic Resection of Gallbladder Cancer: A Single-Center Retrospective Comparative Study to Open Resection.

    Tschuor, Christoph / Pickens, Ryan C / Isenberg, Erin E / Motz, Benjamin M / Salibi, Patrick N / Robinson, Jordan N / Murphy, Keith J / Iannitti, David A / Baker, Erin H / Vrochides, Dionisios / Martinie, John B

    The American surgeon

    2021  Volume 89, Issue 4, Page(s) 888–896

    Abstract: Background: Minimally invasive surgery is gaining support for resection of gallbladder cancer (GBC). This study aims to compare operative and early outcomes of robotic resection (RR) to open resection (OR) from a single institution performing a high ... ...

    Abstract Background: Minimally invasive surgery is gaining support for resection of gallbladder cancer (GBC). This study aims to compare operative and early outcomes of robotic resection (RR) to open resection (OR) from a single institution performing a high volume of robotic HPB surgery.
    Methods: Twenty patients with GBC underwent RR from January 2013 to August 2019. Outcomes were compared to a historical control of 23 patients with OR. Radical cholecystectomy for suspected GBC and completion operations for incidental GBC after routine cholecystectomy were both included.
    Results: Robotic resection had lower blood loss compared to OR (150 vs 350 mL,
    Conclusion: Robotic resection of GBC is safe and efficient, with lower length of hospital stay and blood loss compared to OR. Technical benefits of robotic-assisted surgery may prove advantageous though larger studies are still needed.
    MeSH term(s) Humans ; Gallbladder Neoplasms/pathology ; Robotic Surgical Procedures ; Retrospective Studies ; Treatment Outcome ; Cholecystectomy ; Carcinoma in Situ/surgery ; Laparoscopy
    Language English
    Publishing date 2021-10-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348211047491
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: The development of myelin repair agents for treatment of multiple sclerosis: progress and challenges.

    Murphy, Robert P / Murphy, Keith J / Pickering, Mark

    Bioengineered

    2012  Volume 4, Issue 3, Page(s) 140–146

    Abstract: Multiple Sclerosis (MS) is an inflammatory demyelinating disorder which affects the central nervous system. Multiple sclerosis treatment has traditionally focused on preventing inflammatory damage to the myelin sheath. Indeed, all currently available ... ...

    Abstract Multiple Sclerosis (MS) is an inflammatory demyelinating disorder which affects the central nervous system. Multiple sclerosis treatment has traditionally focused on preventing inflammatory damage to the myelin sheath. Indeed, all currently available disease modifying agents are immunomodulators. However, the limitations of this approach are becoming increasingly clear, leading to the exploration of other potential therapeutic strategies. In particular, targeting the endogenous remyelination system to promote replacement of the lost myelin sheath has shown much promise. As our understanding of remyelination biology advances, the realization of a remyelinating therapeutic comes closer to fruition. In our review, we aim to summarize the limitations of the current immune focused treatment strategy and discuss the potential of remyelination as a new treatment method. Finally, we aim to highlight the challenges in the identification and development of such therapeutics.
    MeSH term(s) Animals ; Drug Evaluation, Preclinical/trends ; Humans ; Multiple Sclerosis/drug therapy ; Multiple Sclerosis/metabolism ; Myelin Sheath/metabolism
    Language English
    Publishing date 2012-11-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2737830-5
    ISSN 2165-5987 ; 2165-5979
    ISSN (online) 2165-5987
    ISSN 2165-5979
    DOI 10.4161/bioe.22835
    Database MEDical Literature Analysis and Retrieval System OnLINE

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