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Topic Review
Activity after Total Hip Arthroplasty
A large proportion of patients under 40 years of age who underwent Total Hip Arthroplasty (THA) increased their physical activity. Eighty-six percent of the patients were highly active, with a UCLA score ≥ 7. Furthermore, the reported MCID, SCB, and PASS for mHHS were achieved by more than 80% of patients
  • 931
  • 23 Nov 2021
Topic Review
Invasive Infections and Probiotics Uses in Children
According to the revised definition of the International Scientific Association for Probiotics and Prebiotics (ISAPP), probiotics are “live microorganisms that when administered in adequate amounts, confer a health benefit on the host”. During the last two decades, interest in probiotic supplements that modify the microbiota to confer health benefits has been growing, leading to the widespread use of many different types of probiotics in both community and healthcare settings.
  • 930
  • 01 Nov 2021
Topic Review
Plasma Exchange in ANCA-Associated Vasculitis
Therapeutic plasma exchange (TPE) is an adjunctive intervention to immunosuppression for the treatment of severe renal involvement or lung hemorrhage in patients with ANCA-associated vasculitis (AAV). The potential pathogenicity of ANCA makes TPE a reasonable treatment approach for the life-threatening complications of AAV.  The largest clinical trial to date, PEXIVAS, failed to demonstrate a clear benefit for TPE in severe AAV. The role of TPE remains controversial across the medical vasculitis community.
  • 929
  • 19 Nov 2021
Topic Review
Mitochondrial Retinopathies
The retina is an exquisite target for defects of oxidative phosphorylation (OXPHOS) associated with mitochondrial impairment. Retinal involvement occurs in two ways, retinal dystrophy (retinitis pigmentosa) and subacute or chronic optic atrophy, which are the most common clinical entities. Both can present as isolated or virtually exclusive conditions, or as part of more complex, frequently multisystem syndromes. In most cases, mutations of mtDNA have been found in association with mitochondrial retinopathy. The main genetic abnormalities of mtDNA include mutations associated with neurogenic muscle weakness, ataxia and retinitis pigmentosa (NARP) sometimes with earlier onset and increased severity (maternally inherited Leigh syndrome, MILS), single large-scale deletions determining Kearns–Sayre syndrome (KSS, of which retinal dystrophy is a cardinal symptom), and mutations, particularly in mtDNA-encoded ND genes, associated with Leber hereditary optic neuropathy (LHON). However, mutations in nuclear genes can also cause mitochondrial retinopathy, including autosomal recessive phenocopies of LHON, and slowly progressive optic atrophy caused by dominant or, more rarely, recessive, mutations in the fusion/mitochondrial shaping protein OPA1, encoded by a nuclear gene on chromosome 3q29.
  • 926
  • 11 Jan 2022
Topic Review
Donation after Circulatory Death in Paediatric Liver Transplantation
In adults, donation after circulatory death (DCD) liver grafts have been used to expand the donor pool with satisfactory results. Although several studies suggest that DCD livers could also be used in paediatric recipients with good outcomes, their utilisation in children is still limited to a small number of reports. Novel organ perfusion strategies could be used to improve organ quality and help to increase the number of DCD grafts utilised for children.
  • 925
  • 25 Mar 2022
Topic Review
Newly Emerging Antiviral Strategies
Various modern innovative methods or integrated paradigms are now being applied to drug discovery for significant resistance in order to simplify the drug process. In recent years, several strategies have been employed to discover novel antiviral agents with new scaffolds and better resistance profiles, including proteolysis targeting chimera (PROTAC), ribonuclease targeting chimera (RIBOTAC), targeted covalent inhibitors, and topology-matching design.
  • 923
  • 16 Feb 2022
Topic Review
Autophagy in Cisplatin Nephrotoxicity
Cisplatin is a potent chemotherapy drug used for the treatment of various types of tumors, but it has remarkable side effects or toxicity in normal tissues. The kidney is highly vulnerable to cisplatin toxicity due to the accumulation of cisplatin in renal tubule cells. Acute kidney injury occurs in 20–30% of patients and manifests as kidney cell death, tissue damage, rapid loss of renal function or renal failure, and even death.
  • 922
  • 24 Nov 2021
Topic Review
Immune-Derived Mediators and Sensory Nerves for Itch Sensation
Although histamine is a well-known itch mediator, histamine H1-receptor blockers often lack efficacy in chronic itch. Recent molecular and cellular based studies have shown that non-histaminergic mediators, such as proteases, neuropeptides and cytokines, along with their cognate receptors, are involved in evocation and modulation of itch sensation. Many of these molecules are produced and secreted by immune cells, which act on sensory nerve fibers distributed in the skin to cause itching and sensitization. This understanding of the connections between immune cell-derived mediators and sensory nerve fibers has led to the development of new treatments for itch.
  • 922
  • 26 Nov 2021
Topic Review
Molecules Used to Prevent Nasal Polyp Recurrences
Chronic rhinosinusitis with nasal polyps (CRSwNP) is the most bothersome phenotype of chronic rhinosinusitis, which is typically characterized by a Type 2 inflammatory reaction, comorbidities and high rates of nasal polyp recurrence, causing severe impact on quality of life. Nasal polyp recurrence rates, defined as the number of patients undergoing revision endoscopic sinus surgery, are 20% within a 5 year period after surgery. The cornerstone of CRSwNP management consists of anti-inflammatory treatment with local corticosteroids. The therapeutic strategies used to prevent nasal polyp recurrence (NPR) after surgical treatment are discussed. 
  • 922
  • 22 May 2023
Topic Review
Pharmacologic Treatment of Congenital Adrenal Hyperplasia during Pregnancy
Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive endocrine disorders characterized by a defect in one or more steps of adrenal steroidogenesis, with subsequent defective synthesis of cortisol, ACTH excess, accumulation of precursors, and their shunting through alternative pathways. Chronic ACTH excess leads to adrenal enlargement. The clinical features of these patients depend on (1) the severity of cortisol deficiency, (2) the presence and severity of other hormonal deficits, and (3) the hormonal excess resulting from the hyperactivation of the remaining adrenal functioning pathways. A genotype–phenotype correlation exists for many but not all of the described mutations, with some genotypes showing variable clinical severity, possibly because of an interplay with different genetic backgrounds. In pregnancy, several new factors come into play: the fetal risk of inheriting CAH mutations; the different impact of such mutations based on the genetic sex of the fetus; the risk of fetal adrenal insufficiency and sexual abnormalities based on the excess or lack of treatment; the benefit/risk ratio of starting or modifying a glucocorticoid therapy for both the patient and the fetus; and the ethical concerns in exploring different treatment strategies. Arguably, CAH patients may have reduced fertility rates and/or higher pregnancy complications. The international guidelines underline that further research is needed on prenatal treatment, how glucocorticoid requirements change during pregnancy, and the risk/benefit ratio of glucocorticoid therapy for non-classical 21-OHD patients. Future advancement and spread of newer fetal genetic testing techniques may improve the benefit/risk ratio of prenatal therapy. Here, the focus is on the current literature to gather information and guidance for clinicians facing these challenges.
  • 920
  • 31 Jan 2023
Topic Review
Eupatilin Suppresses OVA-Induced Asthma
Asthma is a common chronic respiratory inflammatory disease. It is characterized by airway hyperresponsiveness, allergen-specific IgE secretion, mucus hypersecretion, and airway inflammation. In recent years, the incidence of asthma has increased due to increases in indoor dust, pollen, toxic particles, environmental pollutants, and other allergens. It has been reported that many traditional Chinese herbs are effective in reducing asthma symptoms in both humans and animals. Eupatilin, a pharmacologically active flavone extracted from Artemisia argyi, has a variety of pharmacological activities, including anti-inflammatory, anticancer, antioxidant, antiallergic, cardioprotective, and neuroprotective activities. In the present study, eupatilin was found to attenuate OVA-induced asthma by modulating NF-κB, MAPK and Nrf2 signaling pathways for the first time. Eupatilin may be a promising therapeutic agent for the treatment of asthma.
  • 919
  • 15 Mar 2022
Topic Review
Evidence-Based Mechanical Ventilatory Strategies in ARDS
Acute respiratory distress syndrome (ARDS) is an acute, severe lung injury that is characterized by inflammatory cascades, hypoxemia, and diffuse lung involvement. Acute respiratory distress syndrome remains one of the leading causes of morbidity and mortality in critically ill patients despite advancements in the field. Mechanical ventilatory strategies are a vital component of ARDS management to prevent secondary lung injury and improve patient outcomes. 
  • 914
  • 12 Feb 2022
Topic Review
Pharyngeal Colonization by Kingella kingae
Kingella kingae colonizes the oropharynx after the second life semester, and its prevalence reaches 10% between the ages of 12 and 24 months, declining thereafter as children reach immunological maturity. Kingella kingae colonization is characterized by the periodic substitution of carried organisms by new strains. Whereas some strains frequently colonize asymptomatic children but are rarely isolated from diseased individuals, others are responsible for most invasive infections worldwide, indicating enhanced virulence. The colonized oropharyngeal mucosa is the source of child-to-child transmission, and daycare attendance is associated with a high carriage rate and increased risk of invasive disease. Kingella kingae elaborates a potent repeat-in-toxin (RTXA) that lyses epithelial, phagocytic, and synovial cells. This toxin breaches the epithelial barrier, facilitating bloodstream invasion and survival and the colonization of deep body tissues.
  • 913
  • 29 Mar 2022
Topic Review
Advanced Breast Cancer
HER2 positive breast cancer represent about 20% of all breast cancer subtypes and it was considered the subtype with the worst prognosis until the discovery of therapies directed against the HER2 protein. The determination of the status of the HER2 must be very precise and well managed to identify this subtype, and there are very specific and updated guides that allow its characterization to be adjusted. 
  • 909
  • 29 Mar 2022
Topic Review
Technologies to Assess COVID-19 Specific Antigens
In diagnosing SARS-CoV-2 infection, the most widely used test is the molecular testing. Real-time reverse transcription polymerase chain reaction (RT-PCR) is the most well-known and extensively used molecular analysis. The test relies on nucleic acid amplification and detects unique sequences of SARS-CoV-2. The other type of test, the antigen tests, can detect the presence of SARS-CoV-2 without amplifying viral components, but these tests are less sensitive than the molecular ones. Commonly, any negative antigen test is confirmed with a molecular test so that the patient can be declared negative for COVID-19. Both molecular and antigen tests would detect patients in the acute phase of infection.
  • 907
  • 21 Dec 2021
Topic Review
Atopic Dermatitis and Food Allergy
Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune dysregulation, microbiome dysbiosis, genetic and environmental factors. All these interactions are shaping the landscape of AD endotypes and phenotypes. In the “era of allergy epidemic”, the role of food allergy (FA) in the prevention and management of AD is a recently explored area.
  • 904
  • 05 Aug 2022
Topic Review
Pharmacogenetics to Avoid Adverse Reactions in Cardiology
Cardiovascular Diseases (CVs) are one of the main causes of mortality and disability around the world. Advances in drug treatment have greatly improved survival and quality of life in the past decades, but associated adverse events remain a relevant problem. Pharmacogenetics can help individualize cardiovascular treatment, reducing associated toxicities and improving outcomes. Several scientific societies and working groups periodically review available studies and provide consensus recommendations for those gene-drug pairs with a sufficient level of evidence. However, these recommendations are rarely mandatory, and the indications on how to adjust treatment can vary between different guidelines, which limits their clinical applicability. 
  • 903
  • 23 Nov 2021
Topic Review
Hypersensitivity Reactions to Food Additives
Food additives (FAs) are commonly used in prosscessed foods, but hypersensitivity reactions to food additives (HFA) appears to be a rare phenomenon. Identification of the FA responsible for hypersensitivity and its treatment is difficult. Diagnosis is a challenge for the clinician and for the patient. A food diary is a helpful diagnostic tool. It allows diet therapy to be monitored based on the partial or complete elimination of products containing a harmful additive. An elimination diet must not be deficient, and symptomatic pharmacotherapy may be necessary if its application is ineffective.
  • 903
  • 21 Sep 2022
Topic Review
COVID-19 and Pediatric Asthma
A more robust innate immunity and lower ACE-2 receptors expression underlies a lower severity of COVID-19 in children. Moreover, diverse studies suggest that children with asthma do not appear to be disproportionately more affected by COVID-19. This review address the lower severity of COVID-19 in children and the relationships with asthma, atopy and obesity.
  • 897
  • 18 Feb 2021
Topic Review
Severe Fever with Thrombocytopenia Syndrome
Severe fever with thrombocytopenia syndrome (SFTS) is a viral infection transmitted by tick bites. It is often prevalent during spring to summer and is characterized by fever, thrombocytopenia, hemorrhage, and gastrointestinal symptoms.
  • 896
  • 14 Mar 2022
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