1.Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
Lisa ZHAO ; John P. JONES ; Lauren G. ANDERSON ; Zacharoula KONSOULA ; Cynthia D. NEVISON ; Kathryn J. REISSNER ; William PARKER
Clinical and Experimental Pediatrics 2024;67(3):126-139
Despite the worldwide acceptance of acetaminophen (APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade. The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy. Evidence from the pre- and postpartum periods was considered to avoid controversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered. A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited time frames of drug exposure were reviewed. Furthermore, the evidence of why some children are susceptible to APAPinduced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury in susceptible babies and small children.
2.Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
Lisa ZHAO ; John P. JONES ; Lauren G. ANDERSON ; Zacharoula KONSOULA ; Cynthia D. NEVISON ; Kathryn J. REISSNER ; William PARKER
Clinical and Experimental Pediatrics 2024;67(3):126-139
Despite the worldwide acceptance of acetaminophen (APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade. The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy. Evidence from the pre- and postpartum periods was considered to avoid controversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered. A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited time frames of drug exposure were reviewed. Furthermore, the evidence of why some children are susceptible to APAPinduced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury in susceptible babies and small children.
3.Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
Lisa ZHAO ; John P. JONES ; Lauren G. ANDERSON ; Zacharoula KONSOULA ; Cynthia D. NEVISON ; Kathryn J. REISSNER ; William PARKER
Clinical and Experimental Pediatrics 2024;67(3):126-139
Despite the worldwide acceptance of acetaminophen (APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade. The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy. Evidence from the pre- and postpartum periods was considered to avoid controversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered. A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited time frames of drug exposure were reviewed. Furthermore, the evidence of why some children are susceptible to APAPinduced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury in susceptible babies and small children.
4.Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
Lisa ZHAO ; John P. JONES ; Lauren G. ANDERSON ; Zacharoula KONSOULA ; Cynthia D. NEVISON ; Kathryn J. REISSNER ; William PARKER
Clinical and Experimental Pediatrics 2024;67(3):126-139
Despite the worldwide acceptance of acetaminophen (APAP) as a necessary medicine in pediatrics, evidence that early exposure to APAP causes neurodevelopmental injury in susceptible babies and children has been mounting for over a decade. The evidence is diverse and includes extensive work with laboratory animals, otherwise unexplained associations, factors associated with APAP metabolism, and limited studies in humans. Although the evidence has reached an overwhelming level and was recently reviewed in detail, controversy persists. This narrative review evaluates some of that controversy. Evidence from the pre- and postpartum periods was considered to avoid controversy raised by consideration of only limited evidence of risks during the prepartum period. Among other issues, the association between APAP use and the prevalence of neurodevelopmental disorders was considered. A systematic review revealed that the use of APAP in the pediatric population was never tracked carefully; however, historical events that affected its use were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. Moreover, problems with the exclusive reliance on results of meta-analyses of large datasets with limited time frames of drug exposure were reviewed. Furthermore, the evidence of why some children are susceptible to APAPinduced neurodevelopmental injuries was examined. We concluded that available evidence demonstrates that early exposure to APAP causes neurodevelopmental injury in susceptible babies and small children.
5.Identification of new genetic risk factors for prostate cancer.
Michelle GUY ; Zsofia KOTE-JARAI ; Graham G GILES ; Ali Amin Al OLAMA ; Sarah K JUGURNAUTH ; Shani MULHOLLAND ; Daniel A LEONGAMORNLERT ; Stephen M EDWARDS ; Jonathan MORRISON ; Helen I FIELD ; Melissa C SOUTHEY ; Gianluca SEVERI ; Jenny L DONOVAN ; Freddie C HAMDY ; David P DEARNALEY ; Kenneth R MUIR ; Charmaine SMITH ; Melisa BAGNATO ; Audrey T ARDERN-JONES ; Amanda L HALL ; Lynne T O'BRIEN ; Beatrice N GEHR-SWAIN ; Rosemary A WILKINSON ; Angela COX ; Sarah LEWIS ; Paul M BROWN ; Sameer G JHAVAR ; Malgorzata TYMRAKIEWICZ ; Artitaya LOPHATANANON ; Sarah L BRYANT ; null ; null ; null ; Alan HORWICH ; Robert A HUDDART ; Vincent S KHOO ; Christopher C PARKER ; Christopher J WOODHOUSE ; Alan THOMPSON ; Tim CHRISTMAS ; Chris OGDEN ; Cyril FISHER ; Charles JAMESON ; Colin S COOPER ; Dallas R ENGLISH ; John L HOPPER ; David E NEAL ; Douglas F EASTON ; Rosalind A EELES
Asian Journal of Andrology 2009;11(1):49-55
There is evidence that a substantial part of genetic predisposition to prostate cancer (PCa) may be due to lower penetrance genes which are found by genome-wide association studies. We have recently conducted such a study and seven new regions of the genome linked to PCa risk have been identified. Three of these loci contain candidate susceptibility genes: MSMB, LMTK2 and KLK2/3. The MSMB and KLK2/3 genes may be useful for PCa screening, and the LMTK2 gene might provide a potential therapeutic target. Together with results from other groups, there are now 23 germline genetic variants which have been reported. These results have the potential to be developed into a genetic test. However, we consider that marketing of tests to the public is premature, as PCa risk can not be evaluated fully at this stage and the appropriate screening protocols need to be developed. Follow-up validation studies, as well as studies to explore the psychological implications of genetic profile testing, will be vital prior to roll out into healthcare.
Genetic Predisposition to Disease
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genetics
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Genetic Testing
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Humans
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Kallikreins
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genetics
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Male
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Membrane Proteins
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genetics
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Prostatic Neoplasms
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diagnosis
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genetics
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Prostatic Secretory Proteins
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genetics
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Protein-Serine-Threonine Kinases
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genetics
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Risk Factors