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Topic Review
HCC and Molecular Targeting Therapies
Hepatocellular carcinoma (HCC) is one of the leading causes of death from cancer in the world. Recently, the effectiveness of new antiviral therapies and the HBV vaccine have reduced HCC’s incidence, while non-alcoholic steato-hepatitis is an emerging risk factor. This entry focuses on antiangiogenic molecules and immune checkpoint inhibitors approved for HCC treatment and possible future approaches.
  • 955
  • 12 Oct 2021
Topic Review
Relationship between Saliva and Sublingual Immunotherapy
Sublingual immunotherapy (SLIT) can induce the clinical remission of patients from IgE-mediated allergic diseases, but not all patients who undergo SLIT experience substantial improvement in their allergic symptoms. As biomarkers to predict the efficacy of SLIT have been investigated, some of the salivary microorganisms which turn out to be associated with the efficacy of SLIT are detected, and these microorganisms may be used as adjuvants for SLIT in the future.
  • 955
  • 29 Mar 2022
Topic Review
Flavonoid-Containing Dietary Supplements for Micronutrient Deficiency
Micronutrient deficiencies related to vitamins and minerals currently affect more than two billion people globally. Understandably, the highest numbers are recorded in lower-income nations, but there is also a growing trend of these deficiencies in high-income countries such as the U.S., Canada, and the U.K. Environmental factors have greatly reduced the variety and the quantity of flavonoids in our daily diet, leading to potential deficiencies and deficiency-associated illnesses.
  • 954
  • 19 May 2023
Topic Review
Vitamin D in Cardiovascular Diseases
Vitamin D represents a group of secosteroids involved in the calcium and phosphate metabolism. The active form of vitamin D, 1,25-dihydroxylcalciferol, exerts its biological mechanisms via the VDR which acts as a regulator of several target genes.
  • 953
  • 24 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.
  • 953
  • 25 Mar 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.
  • 946
  • 29 Mar 2022
Topic Review
Intermediate- and Therapeutic-Dose Anticoagulation for Patients with COVID-19
COVID-19 patients are at high thrombotic risk. Moderately affected COVID-19 patients may benefit from therapeutic-dose anticoagulation, but the risk for bleeding is increased.
  • 943
  • 12 Jan 2022
Topic Review
Hepatitis C Vaccination
The hepatitis C virus (HCV) is a common cause of chronic liver disease and liver cancer worldwide. Despite advances in curative therapies for HCV, the incidence of new infections is not decreasing at the expected rate to hit the World Health Organization (WHO) target for the elimination of HCV by 2030. In fact, there are still more new cases of infection in the United States and worldwide than are being cured. The reasons for the rise in new cases include poor access to care and the opioid epidemic. The clinical burden of HCV requires a multimodal approach to eradicating the infection. Vaccination would be an excellent tool to prevent incidence of new infections; however, the genetic diversity of HCV and its ability to generate quasispecies within an infected host make creating a broadly reactive vaccine difficult. Multiple vaccine candidates have been identified, but to date, there has not been a target that has led to a broadly reactive vaccine, though several of the candidates are promising. Additionally, the virus is very difficult to culture and testing candidates in humans or chimpanzees is ethically challenging. Despite the multiple barriers to creating a vaccine, vaccination still represents an important tool in the fight against HCV. 
  • 943
  • 07 Feb 2022
Topic Review
Interventions for Early-Stage Pericoronitis
Evidence of low methodological quality and high clinical diversity showed that there are still uncertainties to estimate the effect of the different interventions for pericoronitis. It is important to note that pericoronitis is an inflammation of the tissues around the crown. Until now, initial pericoronitis should be resolved with local irrigation and gently debridement. Antibiotics should be specially reserved for severe cases when systemic dissemination are present. 
  • 943
  • 21 Feb 2022
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.
  • 943
  • 31 Jan 2023
Topic Review
Role of Diet and Nutrition in Allergic Diseases
Allergic diseases are a set of chronic inflammatory disorders of lung, skin, and nose epithelium characterized by aberrant IgE and Th2 cytokine-mediated immune responses to exposed allergens. The prevalence of allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, has increased dramatically worldwide in the past several decades. Evidence suggests that diet and nutrition play a key role in the development and severity of allergic diseases. Dietary components can differentially regulate allergic inflammation pathways through host and gut microbiota-derived metabolites, therefore influencing allergy outcomes in positive or negative ways. A broad range of nutrients and dietary components (vitamins A, D, and E, minerals Zn, Iron, and Se, dietary fiber, fatty acids, and phytochemicals) are found to be effective in the prevention or treatment of allergic diseases through the suppression of type 2 inflammation. 
  • 941
  • 31 Aug 2023
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
  • 940
  • 23 Nov 2021
Topic Review
Clinical Assessment for Allergen Immunotherapy Candidates
Since there is no gold standard for screening tests, physicians should (or should not) order them based on a tailor-made approach to each AIT candidate, taking under consideration contraindications and the predictive value of each test. Undoubtedly, more research is required in order to establish a universal approach.
  • 939
  • 02 Mar 2022
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.
  • 938
  • 05 Aug 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.
  • 936
  • 16 Feb 2022
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.
  • 936
  • 15 Mar 2022
Topic Review
Varicose Veins of the Lower Limbs
One of the early symptoms of chronic venous disease (CVD) is varicose veins (VV) of the lower limbs. There are many etiological environmental factors influencing the development of chronic venous insufficiency (CVI), although genetic factors and family history of the disease play a key role.
  • 933
  • 07 Feb 2024
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.
  • 932
  • 11 Jan 2022
Topic Review
Heavy Metals for Macrophage Polarization in Asthma
Asthma is a chronic inflammatory airway disease characterized by variable airflow obstruction, bronchial hyper-responsiveness, and airway inflammation. The chronic inflammation of the airway is mediated by many cell types, cytokines, chemokines, and inflammatory mediators. Research suggests that exposure to air pollution has a negative impact on asthma outcomes in adult and pediatric populations. Air pollution is one of the greatest environmental risks to health, and it impacts the lungs’ innate and adaptive defense systems. A major pollutant in the air is particulate matter (PM), a complex component composed of elemental carbon and heavy metals. According to the WHO, 99% of people live in air pollution where air quality levels are lower than the WHO air quality guidelines. This suggests that the effect of air pollution exposure on asthma is a crucial health issue worldwide. Macrophages are essential in recognizing and processing any inhaled foreign material, such as PM. Alveolar macrophages are one of the predominant cell types that process and remove inhaled PM by secreting proinflammatory mediators from the lung.
  • 932
  • 31 Oct 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. 
  • 931
  • 29 Mar 2022
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