BACKGROUND: Primary care providers (PCPs), including pediatricians and general practitioners, are often the first to see children with eczema/atopic dermatitis (AD). Little is known about management of pediatric AD by PCPs and adherence to national guidelines. OBJECTIVE: To review existing literature examining management components of pediatric AD (topical corticosteroids [TCS], topical calcineurin inhibitors [TCIs], antihistamines, bathing, emollients, and diet) by PCPs. DATA SOURCES: PubMed/Medline and Embase. STUDY ELIGIBILITY CRITERIA: English-language articles dated 2015 to 2020 reporting outcomes addressing management of pediatric AD by PCPs. STUDY APPRAISAL AND SYNTHESIS METHODS: Two authors independently screened titles/abstracts, reviewed full-text articles, extracted relevant data, and evaluated study quality. Disagreements were resolved by a third author. RESULTS: Twenty articles were included. Surveys and national database analyses were the most common methodologies (n = 7 each). PCPs commonly prescribed TCS but had a preference for low-potency agents, overprescribed nonsedating antihistamines, and avoided TCIs. PCPs commonly recommended emollients, although this was not universal. Data characterizing nonmedication management were limited. LIMITATIONS: Most studies did not examine individual patient encounters, but rather relied on providers reporting their general behaviors. Provider behavior may vary based on country of practice. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Knowledge and management gaps exist among PCPs in treating pediatric AD in key areas including knowledge of TCS safety profiles and prescribing of TCIs. The current literature is largely limited to small studies that evaluate prescribing behaviors with limited data characterizing nonmedication management, highlighting the need for future research in this area.
KEYWORDS: atopic dermatitis | eczema | health care delivery | primary care provider | pediatric

Background: General practitioners (GPs) are among the first health care providers to be involved in prediabetes care, and their actions can prevent patients’ transition from prediabetes to diabetes. However, data on knowledge and management of prediabetes in primary care remain scarce. Aim: To describe the knowledge, attitudes and practices of GPs towards prediabetes. Design and setting: This descriptive cross-sectional study included all private GPs working in Reunion Island.
Method: GPs were sent an electronic questionnaire that specifically sought to establish whether GPs knew the definition of prediabetes and whether their practices were in line with French guidelines for prediabetes screening and management.
Results: A total of 121 GPs completed the questionnaire. Of these, 95.0% knew the definition of impaired fasting glucose, but only 66.1% knew that of impaired glucose tolerance. Many GPs reported practices that are not recommended in guidelines. Thus, 59% of respondents declared that they monitored prediabetes with HbA1c and 10% said that they prescribed oral anti-diabetic drugs as prediabetes treatment. The risks factors associated with prediabetes were generally well known. Although 59.5% of respondents reported not having enough time to provide therapeutic education and medical follow up, only 19% referred their patients to a nutritionist or dietician. Lastly, 93.4% of respondents favoured the implementation of a local therapeutic education program targeting prediabetic individuals.
Conclusion: Prediabetes management in primary care can be made more effective by improving GPs’ knowledge of prediabetes and official guidelines, facilitating referral of prediabetic patients to lifestyle specialists and implementing local therapeutic education programs.
keywords: Prediabetes | Primary Health Care | Secondary Prevention | Health Knowledge | Attitudes | Practice | Diabetes Mellitus.

Aims: Recent research suggests an association between longevity, caloric restriction (CR) and reduction of chronic inflammatory diseases, such as periodontitis. Currently, the mechanisms related to the effects of CR are not yet fully understood. In the present study, we aimed to evaluate the effects of caloric restriction on alveolar bone loss (ABL) in Wistar rats with experimental periodontitis.
Main methods: The impact of CR on biometric data, clinical periodontal parameters, serum biomarkers and biochemical parameters were also investigated. The experimental protocol lasted 24 weeks. The CR rats were fed for 12 weeks with 70% of the standard food compared to the animals with ad libitum diet. Experimental peri- odontitis was induced in Wistar rats during 15 days before the end of the experiment. The animals were divided into four experimental groups (n = 12 animals/group), according to the presence or absence of caloric restriction and ligature-induced periodontitis. Hemimandibles were used to assess ABL.
Key findings: The groups with experimental periodontitis induction showed a significant decrease on alveolar bone loss in animals submitted to caloric restriction, in addition to attenuating gingival inflammation, demon- strated by the significant difference in gingival index. Biochemical and biometric data showed a significant reduction in the glycemic profile, body weight, adiposity index and abdominal circumference after caloric restriction. Caloric restriction did not significantly alter bone tissue biomarkers.
Significance: According to the findings, caloric restriction reduced alveolar bone loss, glycemic profile and bio- metric parameters in rats with experimental periodontitis.
Keywords: Caloric restriction | Periodontitis | Rats

Objective: To assess the perceived and actual role of critical care nurses in nutritional care, and their knowledge regarding the identification and management of hypophosphataemia and refeeding syndrome. Design and methods: Data were collected in one intensive care unit in Israel, from a self-administered questionnaire completed by 42 critical care nurses. The questionnaire was designed to assess their perceived and actual roles in the administration of nutritional care, and knowledge regarding electrolyte monitoring, hypophosphataemia and refeeding syndrome, including risk factors, consequences, and treatment.
Results: The majority participants that dieticians are solely responsible for nutrition care and follow-up. Most agreed that the measurement of phosphate levels was not important and that patients should receive full nutrition upon admission, while important risk factors for the development of refeeding syndrome were not recognised or considered. This informed their actual practice. A correlation was found between nurses’ knowledge and their actual practice so that the greater the nurses’ knowledge, the more they adhered to current nutrition guidelines (p < 0.05).
Conclusions: This study revealed critical care nurses’ lack of clarity of their role and lack of knowledge regarding nutrition care. We suggest that this complex task is best managed by a multidisciplinary team, including nurses and dieticians, with clear role definitions.
keywords: پرستاری مراقبت های ویژه | مطالعه اکتشافی توصیفی | هیپوفسفاتیه | سندرم ریزش | Critical care nursing | Descriptive exploratory study | Hypophosphataemia | Refeeding syndrome

Natural products (NPs) will continue to serve humans asmatchless source of novel drug leads and an inspiration for the synthesis of non-natural drugs. As our scientific understanding of ‘nature’ is rapidly expanding, itwould be worthwhile to illuminate the pharmacological distinctions of NPs to the scientific community and the public. Flavonoids have long fascinated scientists with their remarkable structural diversity as well as biological functions. Consequently, this review aims to shed light on the sources and pharmacological significance of a dietary isoflavone, biochanin A, which has been recently emerged as a multitargeted and multifunctional guardian of human health. Biochanin A possesses anti-inflammatory, anticancer, neuroprotective, antioxidant, anti-microbial, and hepatoprotective properties. It combats cancer development by inducing apoptosis, inhibition of metastasis and arresting cell cycle via targeting several deregulated signaling pathways of cancer. It fights inflammation by blocking the expression and activity of pro-inflammatory cytokines via modulation of NF-κB and MAPKs. Biochanin A acts as a neuroprotective agent by inhibiting microglial activation and apoptosis of neurons. As biochanin A has potential to modulate several biological networks, thus, it can be anticipated that this therapeutically potent compound might serve as a novel lead for drug development in the near future.
Keywords: Biochanin A | Isoflavone | Anticancer | Anti-inflammatory | Antioxidant | Neuroprotective | Anti-microbial