Epidemiology and reporting characteristics of preclinical systematic reviews.

In an effort to better utilize published evidence obtained from animal experiments, systematic reviews of preclinical studies are increasingly more common-along with the methods and tools to appraise them (e.g., SYstematic Review Center for Laboratory animal Experimentation [SYRCLE's] risk of bias tool). We performed a cross-sectional study of a sample of recent preclinical systematic reviews (2015-2018) and examined a range of epidemiological characteristics and used a 46-item checklist to assess reporting details. We identified 442 reviews published across 43 countries in 23 different disease domains that used 26 animal species. Reporting of key details to ensure transparency and reproducibility was inconsistent across reviews and within article sections. Items were most completely reported in the title, introduction, and results sections of the reviews, while least reported in the methods and discussion sections. Less than half of reviews reported that a risk of bias assessment for internal and external validity was undertaken, and none reported methods for evaluating construct validity. Our results demonstrate that a considerable number of preclinical systematic reviews investigating diverse topics have been conducted; however, their quality of reporting is inconsistent. Our study provides the justification and evidence to inform the development of guidelines for conducting and reporting preclinical systematic reviews.

Progress in pediatrics in 2015: choices in allergy, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, nephrology, neurology, nutrition, oncology and pulmonology.

This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature. Epidemiological studies have evidenced the high incidence of Graves' disease and Hashimoto's thyroiditis in patients with Down syndrome. Documentation of novel risk factors for celiac disease are of use to develop strategies for prevention in the population at-risk. Diagnostic criteria for non-celiac gluten sensitivity have been reported. Negative effect on nervous system development of the supernumerary X chromosome in Klinefelter syndrome has emerged. Improvements have been made in understanding rare diseases such as Rubinstein-Taybi syndrome. Eltrombopag is an effective therapy for immune trombocytopenia. Children with sickle-cell anemia are at risk for nocturnal enuresis. Invasive diseases caused by Streptococcus pyogenes are still common despite of vaccination. No difference in frequency of antibiotic prescriptions for acute otitis media between before the publication of the national guideline and after has been found. The importance of timing of iron administration in low birth weight infants, the effect of probiotics for preventing necrotising enterocolitis and perspectives for managing jaundice and cholestasis in neonates have been highlighted. New strategies have been developed to reduce the risk for relapse in nephrotic syndrome including prednisolone during upper respiratory infection. Insights into the pathophysiology of cerebral palsy, arterial ischemic stroke and acute encephalitis may drive advances in treatment. Recommendations on breastfeeding and complementary feeding have been updated. Novel treatments for rhabdomyosarcoma should be considered for paediatric patients. Control of risk factors for bronchiolitis and administration of pavilizumab for preventing respiratory syncytial virus infection may reduce hospitalization. Identification of risk factors for hospitalization in children with wheezing can improve the management of this disease. Deletions or mutations in genes encoding proteins for surfactant function may cause diffuse lung disease.

Molecular pathological epidemiology of epigenetics: emerging integrative science to analyze environment, host, and disease.

Epigenetics acts as an interface between environmental/exogenous factors, cellular responses, and pathological processes. Aberrant epigenetic signatures are a hallmark of complex multifactorial diseases (including neoplasms and malignancies such as leukemias, lymphomas, sarcomas, and breast, lung, prostate, liver, and colorectal cancers). Epigenetic signatures (DNA methylation, mRNA and microRNA expression, etc) may serve as biomarkers for risk stratification, early detection, and disease classification, as well as targets for therapy and chemoprevention. In particular, DNA methylation assays are widely applied to formalin-fixed, paraffin-embedded archival tissue specimens as clinical pathology tests. To better understand the interplay between etiological factors, cellular molecular characteristics, and disease evolution, the field of 'molecular pathological epidemiology (MPE)' has emerged as an interdisciplinary integration of 'molecular pathology' and 'epidemiology'. In contrast to traditional epidemiological research including genome-wide association studies (GWAS), MPE is founded on the unique disease principle, that is, each disease process results from unique profiles of exposomes, epigenomes, transcriptomes, proteomes, metabolomes, microbiomes, and interactomes in relation to the macroenvironment and tissue microenvironment. MPE may represent a logical evolution of GWAS, termed 'GWAS-MPE approach'. Although epigenome-wide association study attracts increasing attention, currently, it has a fundamental problem in that each cell within one individual has a unique, time-varying epigenome. Having a similar conceptual framework to systems biology, the holistic MPE approach enables us to link potential etiological factors to specific molecular pathology, and gain novel pathogenic insights on causality. The widespread application of epigenome (eg, methylome) analyses will enhance our understanding of disease heterogeneity, epigenotypes (CpG island methylator phenotype, LINE-1 (long interspersed nucleotide element-1; also called long interspersed nuclear element-1; long interspersed element-1; L1) hypomethylation, etc), and host-disease interactions. In this article, we illustrate increasing contribution of modern pathology to broader public health sciences, which attests pivotal roles of pathologists in the new integrated MPE science towards our ultimate goal of personalized medicine and prevention.

La epidemiología en la salud pública del futuro / The role of epidemiology in the future of public health

El paso desde una investigación epidemiológica de factores deriesgo a una investigación de carácter poblacional, centrada en lasteorías etiológicas y más ligada al contexto social y ambiental podríaaportar conocimientos que favorezcan la implantación de políticaspúblicas dirigidas a mejorar la salud de la población, pero no logarantizan. En este artículo se comentan diversos factores desde laóptica de la investigación, de la práctica profesional y de la relacióncon los servicios sanitarios que pueden determinar un mejor enlaceentre la epidemiología y las políticas de salud pública. La creatividade innovación, la hibridación con otras disciplinas, el compromisocon los valores que fundamentan la salud pública y un papel preponderanteen los servicios sanitarios son algunos de los factores quepueden mejorar la influencia de la epidemiología en la salud públicadel futuro

The evolution of epidemiology from a risk factor centred approachto a population epidemiology, focused in etiologic theories andmore connected with the social and environmental context couldsupport but not guarantee the implementation of public policiesoriented to improve population health. In this article, we commenton several factors that, from the research, professional and healthservices viewpoints, could determine a better linkage between epidemiologyand public health policies. Creativity and innovation,hybridization, a compromise with the fundamental values of publichealth and a prominent role in health services are some of the mainfactors

Hunting for electrophiles that harm human DNA: Frits Sobels Award Lecture.

This lecture is dedicated to Frits Sobels and his farsighted vision on research directions in genetic toxicology. Some accomplishments by the author's research group in the area of cancer etiology research and pre-clinical drug safety evaluation are presented. Praziquantel, an antischistosomal drug, was found to be devoid of any genetic effects which determined the drug companies to proceed with further safety evaluation and marketing. This highly efficient life-saving drug is now in use world wide. Biomonitoring methods have been developed to quantitate carcinogens, their metabolites or DNA adducts in humans exposed environmentally and endogenously to genotoxic agents. The methods were applied in ecological and case-control studies aimed at establishing causal relationships between exposure and disease. Results from both field studies in Iran and laboratory investigations supported the hypothesis that opium use, in particular ingestion of its pyrolysates, may be a risk factor for esophageal cancer in this region, probably acting together with nutritional deficiencies and thermal injury. By applying the nitrosoproline (NPRO) test in ecological studies on esophageal cancer causation in China some support was obtained for the involvement of N-nitroso compounds. In inhabitants of high risk areas endogenous nitrosamine synthesis could be markedly reduced by ingestion of vitamin C. Ultrasensitive detection methods for etheno-DNA adducts, which are formed by lipid peroxidation products resulting from increased oxidative stress, have been developed. Known cancer risk factors such as metal storage, chronic inflammatory processes and a high omega-6 PUFA fat diet increased the background level of these miscoding DNA adducts many times. They were found to increase progressively in premalignant lesions of cancer-prone tissues of humans and rodents, probably contributing to the genetic instability that drives cells to malignancy. Etheno-DNA adducts are thus promising markers to verify the efficiency of chemopreventive measures in humans.

[Epidemiology, social medicine, environmental medicine--a plea for a difficult but necessary integration]. / Epidemiologie, Sozialmedizin, Umweltmedizin--Plädoyer für eine schwierige, aber notwendige Integration.

The origins of environmental medicine date back more than 2000 years. The increasing incidence of environmental disease together with successful research into their etiology and pathogenesis have caused an impetus for this discipline in quantitative terms. A growing interest of patients, but also of politicians and parts of the industry in actual or suspected environmental risk factors for health have given rise to controversies--rendering the development of a rational, quality-oriented environmental medicine difficult, if not impossible. Given these controversies surrounding environmental health issues formal demarcations between the traditional disciplines (environmental) epidemiology, social medicine, occupational medicine, and environmental medicine become obsolete. Instead, a common agenda with respect to research, quality assurance, risk communication, and prevention as well as patient counselling and policy advising calls for a conceptual and institutional integration of these disciplines.

Presentation: Epidemiology and public health: is a new paradigm needed or a new ethic?

Public health militancy has been increasingly frustrated by what many perceive as the marginally fertile studies of risk factors operating at the individual level, whose causal underpinnings are often and inevitably weakened in multifactorial situations. As a remedy, leading advocates propose a refocusing of epidemiology and public health on socioeconomic, cultural, and political studies, and on broad interventions at population level. This new "paradigm" would be aided by a relaxation of evidentiary standards of causality, away from scientific criteria and more toward dialectic (rhetorical) precepts derived in a humanistic and sociologic tradition. It is countered here that such proposals would further reduce the objectivity and thus likely weaken rather than strengthen epidemiology and the justification of public health action. Instead, a realistic appraisal finds that multifactorial epidemiology raises warning signals of varying influence, and that the usefulness of epidemiology and public health could be enhanced by conceiving of methods to score the relative strength and priority of such warnings.

Complexity and human health: the case for a transdisciplinary paradigm.

Transdisciplinary thinking is an emerging philosophy underpinning health social science. We advance a definition of transdisciplinary thinking and link it with complexity theory. Complexity theory's concern with non-linear relationships, interactive causality and emergent properties of systems compels researchers to adopt a transdisciplinary perspective. We construct a generic framework for analyzing health processes from diverse disciplines and apply it to coronary heart disease in the Australian Coalfields. Insights from this analysis support our argument that transdisciplinary thinking maximizes understanding of the complexity of human health.

Epidemiology, evidenced-based medicine, and evidence-based public health.

Evidence-Based Medicine (EBM) is heralded as a new paradigm of medicine. Is it? What is its link to epidemiology? Does an evidence-based (EB) approach apply also to other health sciences and to public health in particular? What has epidemiology already achieved in these domains, and what remains to be done? What should our priorities be in the coming years? The EB approach is essential in all health sciences at two levels: for problem solving, and for decision making. It applies to all health sciences, be it medicine, nursing, public health, or others. Many epidemiological principles, methods and techniques are put into good use in EBM. The EB "movement" is attractive in it's use of clearly defined procedures, generalizing (not always explicitly) the application of good epidemiologic principles, methods, and techniques. Epidemiology must now contribute to the evaluation of the practice of an EB approach. If one does not have access to a good medical library nor information technology does the EBM paradigm still hold? Hence, clinical and public health guidelines will benefit first from the EBM approach, then daily practice of EBM will follow, conditions permitting. In public health, the challenges of the EB practice are not equally spread across health protection, different levels of disease prevention, and health promotion. The latter represents the most challenging task for epidemiology at any step of EB approach. Epidemiology, if successful in this domain, may help to build an EB health promotion. An Evidence-Based Public Health paradigm may be considered.

Acidentes provocados por Physalia sp (caravelas): 238 casos relatados no litoral catarinense / Accidents caused by physalia sp (man of war): 238 cases reported in the catarinense seashore

A espécie Physalia sp é o tipo de caravela mais freqüente e de maior atividade tóxica do litoral brasileiro, causando acidentes por contatos, com sintomatologia de dor, eritema, prurido, contrações musculares, vômitos, podendo ocorrer também hemólise, insuficiência renal e choque anafilático. Analisou-se a frequencia destes acidentes, notificados ao centro de Informações Toxicológicas (CIT/SC) no período de 1984 a 1996....

Tos ferina (Coqueluche) / Whooping cougth

La tos ferina es una enfermedad respiratoria infecto contagiosa endémica y epidérmica, causada por la Bordetella pertussis, que se presenta con mayor frecuencia en menores de 5 años. La primera descripción de tos ferina fue realizada por Guillermo de Baillou en París en 1578 durante una epidemia de la enfermedad. En 1670 Sydenham le da el nombre de tos ferina (tos intensa) a esta infección. En China se la conoce como "la tos de los 100 dias". Aunque se dispone de una vacuna efectiva, la moratlidad en lactantes y niños pequeños de países en vías de desarrollo continúa siendo elevada, debido a la falta de inmunización o vacunación incompleta. El objetivo de esta revisión es recordar y actualizar conceptos acerca de este padecimiento.

Epidemiología y Homeopatía: son compatibles? Podemos hacer estadísticas en Homeopatía? / Epidemiology and Homeopathy: are compatibles?

En este artículo se hace una reflexión acerca de la posibilidad de utilizar métodos estadísticos en Homeopatía. Se presenta aquí una propueta para realizar un trabajo de investigación utilizando métodos estadísticos y epidemiológicos, en Homeopatía

Epidemiología y Homeopatía: son compatibles? Podemos hacer estadísticas en Homeopatía? / Epidemiology and Homeopathy: are compatibles?

En este artículo se hace una reflexión acerca de la posibilidad de utilizar métodos estadísticos en Homeopatía. Se presenta aquí una propueta para realizar un trabajo de investigación utilizando métodos estadísticos y epidemiológicos, en Homeopatía (AU)