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As survival of extremely preterm infants continues to improve, there is also an associated increase in bronchopulmonary dysplasia (BPD), one of the most significant complications of preterm birth. BPD development is multifactorial resulting from exposure to multiple antenatal and postnatal stressors. BPD has both short-term health implications and long-term sequelae including increased respiratory, cardiovascular and neurological morbidity. Transforming growth factor beta (TGF-b) is an important signaling pathway in lung development, organ injury and fibrosis and is implicated in the development of BPD. This review provides a detailed account on the role of TGF-b in antenatal and postnatal lung development, the effect of known risk factors for BPD on the TGF-b signaling pathway, and how medications currently in use or under development, for the prevention or treatment of BPD, affect TGF-b signaling.

Water-soluble fiber has been reported to reduce serum cholesterol and consequently, oat bran, which has a high soluble-fiber content, has been recommended as part of a lipid-lowering diet. However, a recent small study of 20 volunteers with low mean serum cholesterol concentrations (4.8 mmol/L) demonstrated no lipid-lowering effect of oat bran. The present study investigated 64 volunteers with cholesterol concentrations much more typical of the UK population (6 mmol/L). Subjects were randomly allocated to receive either a normal-sized helping of an oat-based cereal or a cereal containing no oats for 4 wk and then crossed over to the alternative regimen for a further 4 wk. Small (2.23% and 4.55%) but significant (P < 0.04 and P < 0.05) reductions in total and low-density-lipoprotein cholesterol, respectively, were observed in association with the consumption of oat-based cereal. These data support the view that consumption of oat-based cereals may well contribute usefully to a lipid-lowering diet.

T ourette's syndrome and tic disorders affect around 1% of the population. The presentation can range from relatively innocuous stereotyped movements and noises, through to more severe symptoms resulting in significant social and psychological disability. Although the majority of tic disorders present in childhood, a third of those affected experience tics into adulthood. The prevalence suggests that most GPs will have patients with tic disorders in their practice. The GP curriculum and Tourette's syndrome and tic disorders Clinical module 3.04: Care of children and young people requires GPs to:. Have a thorough understanding of normal development, and be able to recognise delayed development through childhood and adolescence. Recognise children and young people who are at risk in some way, whether physically, mentally or emotionally. Psychological problems: e.g. enuresis, encopresis, bullying, school refusal, behaviour problems including tantrums Clinical module 3.10: Care of people with mental health problems requires GPs to:. Recognise early indicators of difficulty in the psychological well-being of children and young people and respond quickly to concerns raised by parents, family members, early-years workers, teachers and others who are in close contact with the child or young person Tourette's syndrome (TS) is a common disorder starting in childhood, with the presence of motor or vocal tics for over 1 year. Although symptoms in some patients are mild, requiring little beyond information, in others, tics can be socially and psychologically disabling (Foltynie, 2016). With a prevalence of between 0.3 and 0.9% (Scharf et al., 2015), it is perhaps surprising that the disorder remains poorly understood. It is likely that most GPs will have patients with TS in their practice. What are tics? Tics are stereotyped, repetitive and sudden movements or noises that are involuntary or partly voluntary in response to an urge. They are purposeless and repetitive, ranging from simple motor tics (such as blinking and eye twitching), or vocal tics (such as grunting or barking), through to complex motor tics (such as spinning and brushing) and more complex vocal tics (typically words or phrases that are out of context). Table 1 outlines different complex and simple tics. Tics vary in frequency and intensity, and typically occur in bouts. Tics can be briefly suppressed, and are better during sleep or when the sufferer is being distracted, but are often worsen with stress. The stress of being bullied or of receiving unwanted attention, often because of the tics, can exacerbate tics, establishing a vicious cycle. Unlike other movement disorders, such as myoclonic jerks, dystonia and spasms, patients can suppress the tic for a brief period. The ability to suppress the tic (motor or vocal) distinguishes tics from other movement disorders. Suppression of tics requires significant concentration and may increase anxiety and the urge to make the noise or