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Topic Review
Machiavellianism
Machiavellianism is "the employment of cunning and duplicity in statecraft or in general conduct". The word comes from the Italian Renaissance diplomat and writer Niccolò Machiavelli, born in 1469, who wrote Il Principe (The Prince), among other works. In modern psychology, Machiavellianism is one of the dark triad personalities, characterized by a duplicitous interpersonal style, a cynical disregard for morality, and a focus on self-interest and personal gain.
  • 2.2K
  • 13 Oct 2022
Topic Review
DPP4 Inhibitors on COVID19 Outcomes
Although relatively new in the therapeutic landscape for managing type 2 diabetes (T2D), dipeptidyl-peptidase 4 (DPP4) inhibitors have gained widespread popularity, due to their glycemic efficacy, low risk of hypoglycemic episodes and oral route of administration. DPP4, a cell-bound serine protease abundantly expressed on lymphocytes, epithelial and endothelial cells, plays critical roles in the modulation of glucose homeostasis and inflammatory immune responses. Also, given its potential to serve as an adjunctive functional receptor for the emerging Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) to gain entry into the host, inhibition of DPP4 has been proposed as an alternative and multifaceted strategy to prevent severe clinical manifestations of the SARS-CoV-2 related illness (COVID-19), which are commonly observed in T2D patients. However, the inherent risk of mast cells hyper-activation and the lack of a clear demonstration of SARS-CoV-2 binding to DPP4, may raise some concerns and controversy.
  • 2.2K
  • 06 Nov 2020
Topic Review
3DP Medicines and Medical Devices
Novel additive manufacturing (AM) techniques and particularly 3D printing (3DP) have achieved a decade of success in pharmaceutical and biomedical fields. Highly innovative personalized therapeutical solutions may be designed and manufactured through a layer-by-layer approach starting from a digital model realized according to the needs of a specific patient or a patient group. The combination of patient-tailored drug dose, dosage, or diagnostic form (shape and size) and drug release adjustment has the potential to ensure the optimal patient therapy. This document provides an overview on different 3DP techniques to produce personalized medicines and medical devices, highlighting, for each method, the critical printing process parameters, the main starting materials, as well as advantages and limitations.
  • 2.2K
  • 17 May 2022
Topic Review
Paranoid Personality Disorder
Paranoid personality disorder (PPD) is a mental illness characterized by paranoid delusions, and a pervasive, long-standing suspiciousness and generalized mistrust of others. People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other interpretations or evidence. They tend to be guarded and suspicious and have quite constricted emotional lives. Their reduced capacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience. People with PPD may have a tendency to bear grudges, suspiciousness, tendency to interpret others' actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right. Patients with this disorder can also have significant comorbidity with other personality disorders, such as schizotypal, schizoid, narcissistic, avoidant and borderline.
  • 2.2K
  • 08 Nov 2022
Topic Review
BTSB Anti-D Scandal
In 1994, the Irish Blood Transfusion Service Board (BTSB) informed the Minister for Health that a blood product they had distributed in 1977 for the treatment of pregnant mothers had been contaminated with the Hepatitis C virus. Following a report by an expert group, it was discovered that the BTSB had produced and distributed a second infected batch in 1991. The Government established a Tribunal of Inquiry to establish the facts of the case and also agreed to establish a tribunal for the compensation of victims but seemed to frustrate and delay the applications of these, in some cases terminally, ill women. This controversy also sparked an examination of the BTSB's lax procedures for screening blood products for the treatment of Haemophilia and exposed the infection of many Haemophiliacs with HIV, Hepatitis B and Hepatitis C.
  • 2.2K
  • 30 Nov 2022
Topic Review
Gender Dysphoria in Children
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent (gender dysphoria) due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder. Gender dysphoria in preadolescent children is more heavily linked to adult homosexuality than to an adult transgender identity, especially with regard to boys. According to prospective studies, the majority of children diagnosed with gender dysphoria cease to desire to be the other sex by puberty, with most growing up to identify as gay, lesbian, or bisexual, with or without therapeutic intervention. If the dysphoria persists during puberty, it is very likely permanent. Controversy surrounding the pathologization and treatment of a transgender identity and associated behaviors, particularly in children, has been evident in the literature since the 1980s. Proponents of the GD diagnoses argue that therapeutic intervention helps children be more comfortable in their bodies, have better peer relations and therefore better self-esteem, that research indicates there exist forms of distress associated directly with children's gender variance, and that treatment can prevent adult GD. Opponents have compared therapeutic interventions that aim to alter a child's gender identity to conversion (or reparative) therapy for gay men and lesbians. The World Professional Association for Transgender Health (WPATH) states that treatment aimed at trying to change a person's gender identity and gender expression to become more congruent with sex assigned at birth "is no longer considered ethical." Critics also argue that therapeutic interventions that aim to alter a child's gender identity rely on the assumption that an adult transgender identity is undesirable, challenging this assumption along with the lack of clinical data to support outcomes and efficacy. Other therapeutic interventions do not seek to change a child's gender identity, but are instead focused on creating a supportive and safe environment for the child to explore their gender identity and gender expression.
  • 2.2K
  • 14 Oct 2022
Topic Review
Emotion and Memory
Emotion can have a powerful effect on humans and animals. Numerous studies have shown that the most vivid autobiographical memories tend to be of emotional events, which are likely to be recalled more often and with more clarity and detail than neutral events. The activity of emotionally enhanced memory retention can be linked to human evolution; during early development, responsive behavior to environmental events would have progressed as a process of trial and error. Survival depended on behavioral patterns that were repeated or reinforced through life and death situations. Through evolution, this process of learning became genetically embedded in humans and all animal species in what is known as flight or fight instinct. Artificially inducing this instinct through traumatic physical or emotional stimuli essentially creates the same physiological condition that heightens memory retention by exciting neuro-chemical activity affecting areas of the brain responsible for encoding and recalling memory. This memory-enhancing effect of emotion has been demonstrated in many laboratory studies, using stimuli ranging from words to pictures to narrated slide shows, as well as autobiographical memory studies. However, as described below, emotion does not always enhance memory.
  • 2.1K
  • 28 Sep 2022
Topic Review
Behavioral Neuroscience
Behavioral neuroscience, also known as biological psychology, biopsychology, or psychobiology, is the application of the principles of biology to the study of physiological, genetic, and developmental mechanisms of behavior in humans and other animals.
  • 2.1K
  • 23 Nov 2022
Topic Review
Saline
Saline (also known as saline solution) is a mixture of sodium chloride (salt) and water. It has a number of uses in medicine including cleaning wounds, removal and storage of contact lenses, and help with dry eyes. By injection into a vein it is used to treat dehydration such as that from gastroenteritis and diabetic ketoacidosis. Large amounts may result in fluid overload, swelling, acidosis, and high blood sodium. In those with long-standing low blood sodium, excessive use may result in osmotic demyelination syndrome. Saline is in the crystalloid family of medications. It is most commonly used as a sterile 9 g of salt per litre (0.9%) solution, known as normal saline. Higher and lower concentrations may also occasionally be used. Saline is acidic, with a pH of 5.5 (due mainly to dissolved carbon dioxide). The medical use of saline began around 1831. It is on the World Health Organization's List of Essential Medicines. In 2019, sodium was the 226th most commonly prescribed medication in the United States, with more than 2 million prescriptions.
  • 2.1K
  • 13 Oct 2022
Topic Review
Transfusion Associated Circulatory Overload
In transfusion medicine, transfusion associated circulatory overload (aka TACO) is a transfusion reaction (an adverse effect of blood transfusion) resulting in signs or symptoms of excess fluid in the circulatory system (hypervolemia) within 12 hours after transfusion. The symptoms of TACO can include shortness of breath (dyspnea), low blood oxygen levels (hypoxemia), leg swelling (peripheral edema), high blood pressure (hypertension), and a high heart rate (tachycardia). It can occur due to a rapid transfusion of a large volume of blood but can also occur during a single red blood cell transfusion (about 15% of cases). It is often confused with transfusion-related acute lung injury (TRALI), another transfusion reaction. The difference between TACO and TRALI is that TRALI only results in symptoms of respiratory distress while TACO can present with either signs of respiratory distress, peripheral leg swelling, or both. Risk factors for TACO are diseases that increase the amount of fluid a person has, including liver, heart, or kidney failure, as well as conditions that require many transfusions. High and low extremes of age are a risk factor as well. The management of TACO includes immediate discontinuation of the transfusion, supplemental oxygen if needed, and medication to remove excess fluid.
  • 2.1K
  • 18 Oct 2022
Topic Review
RAS/RAF/MAPK/ERK Signaling Pathways of Vascular Anomalies
Vascular anomalies (VAs) are morphogenesis defects of the vascular system (arteries, capillaries, veins, lymphatic vessels) singularly or in complex combinations, sometimes with a severe impact on the quality of life. The main function of the RAS/RAF/MAPK/ERK signaling pathway, also called the “proliferation pathway”, is to transduce signals from the extracellular milieu to the cell nucleus where specific genes are activated for cell cycle regulation, proliferation, and cell migration.
  • 2.1K
  • 31 Oct 2022
Topic Review
Chlamydia Infection
Chlamydia infection, often simply known as chlamydia, is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. Most people who are infected have no symptoms. When symptoms do develop this can take a few weeks following infection to occur. Symptoms in women may include vaginal discharge or burning with urination. Symptoms in men may include discharge from the penis, burning with urination, or pain and swelling of one or both testicles. The infection can spread to the upper genital tract in women causing pelvic inflammatory disease which may result in future infertility or ectopic pregnancy. Repeated infections of the eyes that go without treatment can result in trachoma, a common cause of blindness in the developing world. Chlamydia can be spread during vaginal, anal, or oral sex, and can be passed from an infected mother to her baby during childbirth. The eye infections may also be spread by personal contact, flies, and contaminated towels in areas with poor sanitation. Chlamydia trachomatis only occurs in humans. Diagnosis is often by screening which is recommended yearly in sexually active women under the age of twenty five, others at higher risk, and at the first prenatal visit. Testing can be done on the urine or a swab of the cervix, vagina, or urethra. Rectal or mouth swabs are required to diagnose infections in those areas. Prevention is by not having sex, the use of condoms, or having sex with only one other person, who is not infected. Chlamydia can be cured by antibiotics with typically either azithromycin or doxycycline being used. Erythromycin or azithromycin is recommended in babies and during pregnancy. Sexual partners should also be treated and the infected people advised not to have sex for seven days and until symptom free. Gonorrhea, syphilis, and HIV should be tested for in those who have been infected. Following treatment people should be tested again after three months. Chlamydia is one of the most common sexually transmitted infections, affecting about 4.2% of women and 2.7% of men worldwide. In 2015 about 61 million new cases occurred globally. In the United States about 1.4 million cases were reported in 2014. Infections are most common among those between the ages of 15 and 25 and are more common in women than men. In 2015 infections resulted in about 200 deaths. The word "chlamydia" is from the Greek, χλαμύδα meaning "cloak".
  • 2.1K
  • 06 Oct 2022
Topic Review
Fluoxetine-Mediated CYP2D6 Inhibition
Fluoxetine is still one of the most widely used antidepressants in the world. The drug is extensively metabolized by several cytochrome P450 (CYP450) enzymes and subjected to a myriad of CYP450-mediated drug interactions. In a multidrug regimen, preemptive mitigation of drug–drug interactions requires knowledge of fluoxetine actions on these CYP450 enzymes. The major metabolic pathway of fluoxetine leading to the formation of its active metabolite, norfluoxetine, is mediated by CYP2D6. Fluoxetine and norfluoxetine are strong affinity substrates of CYP2D6 and can inhibit, potentially through various mechanisms, the metabolism of other sensitive CYP2D6 substrates. Remarkably, fluoxetine-mediated CYP2D6 inhibition subsides long after fluoxetine first passes through the liver and even remains long after the discontinuation of the drug. The long-term inhibition of CYP2D6 is likely a result of competitive inhibition due to 1) the strong affinity binding of fluoxetine and norfluoxetine to the enzyme and 2) unbound fluoxetine and norfluoxetine levels circulating in the blood for a long period of time because of their long elimination half-life.
  • 2.1K
  • 04 Feb 2021
Topic Review
Hypoactive Sexual Desire Disorder
Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is considered a sexual dysfunction in some jurisdictions and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug (legal or illegal), or some other medical condition. A person with ISD will not start, or respond to their partner's desire for, sexual activity. HSDD affects approximately 10% of all pre-menopausal women in the United States, or about 6 million women. There are various subtypes. HSDD can be general (general lack of sexual desire) or situational (still has sexual desire, but lacks sexual desire for current partner), and it can be acquired (HSDD started after a period of normal sexual functioning) or lifelong (the person has always had no/low sexual desire.) In the DSM-5, HSDD was split into male hypoactive sexual desire disorder and female sexual interest/arousal disorder. It was first included in the DSM-III under the name inhibited sexual desire disorder, but the name was changed in the DSM-III-R. Other terms used to describe the phenomenon include sexual aversion and sexual apathy. More informal or colloquial terms are frigidity and frigidness.
  • 2.1K
  • 31 Oct 2022
Topic Review
Autistic Enterocolitis
Autistic enterocolitis is the name of a nonexistent medical condition proposed by discredited United Kingdom gastroenterologist Andrew Wakefield when he suggested a link between a number of common clinical symptoms and signs which he contended were distinctive to autism. The existence of such an enterocolitis has been dismissed by experts as having "not been established". Wakefield's fraudulent and now-retracted report used inadequate controls and suppressed negative findings, and multiple attempts to replicate his results have been unsuccessful. Reviews in the medical literature have found no link between the MMR vaccine and autism or bowel disease. Most of Wakefield's coauthors later retracted the conclusions of the original paper proposing the hypothesis, and the General Medical Council found Wakefield guilty of manipulating patient data and misreporting results. His work has been exposed as falsified and described as an "elaborate fraud".
  • 2.1K
  • 14 Oct 2022
Topic Review
Bland–Altman Agreement Analysis
The Bland–Altman Limits of Agreement is a popular and widespread means of analyzing the agreement of two methods, instruments, or raters in quantitative outcomes. An agreement analysis could be reported as a stand-alone research article but it is more often conducted as a minor quality assurance project in a subgroup of patients, as a part of a larger diagnostic accuracy study, clinical trial, or epidemiological survey. Consequently, such an analysis is often limited to brief descriptions in the main report. Therefore, in several medical fields, it has been recommended to report specific items related to the Bland–Altman analysis. Seven proposals were identified from a MEDLINE/PubMed search on March 03, 2020, three of which were derived by reviewing anesthesia journals. Broad consensus was seen for the a priori establishment of acceptability benchmarks, estimation of repeatability of measurements, description of the data structure, visual assessment of the normality and homogeneity assumption, and plotting and numerically reporting both bias and the Bland–Altman Limits of Agreement, including respective 95% confidence intervals. Abu-Arafeh et al. provided the most comprehensive and prudent list, identifying 13 key items for reporting (Br. J. Anaesth. 2016, 117, 569–575). The 13 key items should be applied by researchers, journal editors, and reviewers in the future, to increase the quality of reporting Bland–Altman agreement analyses.
  • 2.1K
  • 27 Oct 2020
Topic Review
Biomarkers in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and one of the leading causes of cancer-related death worldwide. HCC is highly heterogeneous, both within the tumor and among individuals, which is closely related to the HCC surveillance, diagnosis, prognosis, and treatment response. With the advances of next-generation sequencing, the genomic landscape of HCC has been identified which vastly improves our understanding of genetic and epigenetic changes and their interaction during HCC development.
  • 2.1K
  • 28 Sep 2022
Topic Review
Refugee Children
Nearly half of all refugees are children, and almost one in three children living outside their country of birth is a refugee. These numbers encompass children whose refugee status has been formally confirmed, as well as children in refugee-like situations. In addition to facing the direct threat of violence resulting from conflict, forcibly displaced children also face various health risks, including: disease outbreaks and long-term psychological trauma, inadequate access to water and sanitation, nutritious food, and regular vaccination schedules. Refugee children, particularly those without documentation and those who travel alone, are also vulnerable to abuse and exploitation. Although many communities around the world have welcomed them, forcibly displaced children and their families often face discrimination, poverty, and social marginalization in their home, transit, and destination countries. Language barriers and legal barriers in transit and destination countries often bar refugee children and their families from accessing education, healthcare, social protection, and other services. Many countries of destination also lack intercultural supports and policies for social integration. Such threats to safety and well-being are amplified for refugee children with disabilities.
  • 2.1K
  • 24 Oct 2022
Topic Review
Galectin-3: Early Stage Pathophysiological Marker
Galectins are composed of a family of widely expressed β-galactoside-binding lectins and can modulate basic cellular functions such as “cell-to-cell” and “cell-to-matrix” interactions, cell growth and differentiation, tissue regeneration and the regulation of immune cell activities [1][2][3]. Galectins have been classified according to their carbohydrate recognition domain (CRD) number and function. The CRDs recognize β-galactoside residues that form complexes that crosslink glycosylated ligands [4][5][6]. The following three types of galectin members are widely accepted (Figure 1): (1) prototype galectins (galectin-1, -2, -5, -7, -10, -11, -13, -14, and -15), containing a single CRD that form noncovalent homodimers; (2) tandem-repeat galectins (galectin-4, -6, -8, -9, and -12), carrying two CRD motifs connected by a peptide linker and (3) a chimera-type galectin (Gal-3), which is characterized by having a single CRD and an amino-terminal polypeptide tail region [2][5][6]. The members of galectins, numbered consecutively by order of discovery, are ubiquitously present in vertebrates, invertebrates and, also, protists [1].
  • 2.1K
  • 27 Oct 2020
Topic Review
Substance Dependence
Substance dependence, also known as drug dependence, is a biopsychological situation where-by an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance, because of an adaptive state that has developed with the individual from psychoactive substance consumption, which results in the experience of withdrawal, which necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence. The International Classification of Diseases classifies substance dependence as a mental and behavioural disorder. Within the framework of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), substance dependence is redefined as a drug addiction, and can be diagnosed without the occurrence of a withdrawal syndrome. It was described accordingly: "When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse are considered Substance Use Disorders." In the DSM-5 (released in 2013), substance abuse and substance dependence have been merged into the category of substance use disorders and they no longer exist as individual diagnoses.
  • 2.1K
  • 25 Oct 2022
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