Analysis Of Clinical Literature Research Articles

Understanding the role of placental pathophysiology in the development of bronchopulmonary dysplasia.

The associations between bronchopulmonary dysplasia (BPD) and the gestational pathologies of chorioamnionitis (CA) and hypertensive disorders of pregnancy (HDP) have become increasingly well recognized. However, the mechanisms through which these antenatal conditions cause increased risk of BPD remain less well characterized. The objective of this review is to discuss the role of the placenta in BPD predisposition as a primary driver of intrauterine alterations adversely impacting fetal lung development. We hypothesize that due to similarities in structure and function, placental disorders during pregnancy can uniquely impact the developing fetal lung, creating a unique placental-pulmonary connection. In the current review, we explore this hypothesis through analysis of clinical literature and preclinical model systems evaluating BPD predisposition, discussion of BPD phenotypes, and an overview on strategies to incorporate placental investigation into research on fetal lung development. We also discuss important concepts learned from research on antenatal steroids as a modulator fetal lung development. Finally, we propose that the appropriate selection of animal models and establishment of in vitro lung developmental model systems incorporating primary human placental components are key in continuing to understand and address antenatal predisposition to BPD.

Analysis of clinical literature on acupuncture-moxibustion for dyspepsia based on data mining

To summarize the point selection pattern and treatment method in acupuncture-moxibustion for dyspepsia through data mining of the related clinical literatures in recent two decades, and to provide reference for clinical application. With data mining technology, clinical literatures related to acupuncture-moxibustion for dyspepsia published between January 1997 and July 2018 were collected from major Chinese databases, and the treatment methods, point and meridian frequencies were summarized and analyzed. A total of 106 studies were included. For meridians, the top 5 meridians used were the Stomach Meridian, Conception Vessel, Spleen Meridian, Liver Meridian and Pericardium Meridian. For point selection, the leading 5 points were Zusanli (ST 36), Zhongwan (CV 12), Shangwan (CV 13), Xiawan (CV 10) and Sanyinjiao (SP 6). For major and adjunct points, the 5 most significant major points were Zusanli (ST 36), Zhongwan (CV 12), Neiguan (PC 6), Sanyinjiao (SP 6) and Shangwan (CV 13); the 5 most significant adjunct points were Neiting (ST 44), Qihai (CV 6), Fenglong (ST 40), Yinlingquan (SP 9) and Tianshu (ST 25). For treatment method, the top 3 methods used were moxibustion alone, acupuncture alone and acupuncture combined with medicinal herbs. The main meridian chosen in acupuncture-moxibustion for dyspepsia was the Stomach Meridian, and the points were mainly selected from the Stomach Meridian; treatment method was moxibustion alone, which may provide reference for clinical treatment of this disease.

Death denial: obstacle or instrument for palliative care? An analysis of clinical literature

As a society and as individuals, we have come to recognize ourselves as 'death-denying', a self-characterisation particularly prominent in palliative care discourse and practice. As part of a larger project examining death attitudes in the palliative care setting, a Medline search (1971 to 2001) was performed combining the text words 'deny' and 'denial' with the subject headings 'terminal care', 'palliative care' and 'hospice care'. The 30 articles were analysed using a constant comparison technique and emerging themes regarding the meaning and usage of the words deny and denial were identified. This paper examines the theme of denial as an obstacle to palliative care. In the articles, denial was described as an impediment to open discussion of dying, dying at home, stopping 'futile' treatments, advance care planning and control of symptoms. I suggest that these components of care together constitute what has come to be perceived as a correct 'way to die'. Indeed, the very conceptualisation of denial as an obstacle to these components of care has been integral to building and sustaining the 'way to die' itself. The personal struggle with mortality has become an important instrument in the public problem of managing the dying process.