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Topic Review

Primary Localized Cutaneous Nodular Amyloidosis and Sjögren’s Syndrome

Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare condition attributed to plasma cell proliferation and the deposition of immunoglobulin light chains in the skin without association with systemic amyloidosis or hematological dyscrasias. It is not uncommon for patients diagnosed with PLCNA to also suffer from other auto-immune connective tissue diseases, with Sjögren’s syndrome (SjS) showing the strongest association.

762
06 May 2023

Topic Review

Relationship between Obesity and Bone Health

Scientific evidence has shown an increased risk of fractures in patients with obesity, especially in those with a higher visceral adipose tissue content. This contradicts the old paradigm that obese patients were more protected than those with normal weight. Specifically, in older subjects in whom there is a redistribution of fat from subcutaneous adipose tissue to visceral adipose tissue and an infiltration of other tissues such as muscle with the consequent sarcopenia, obesity can accentuate the changes characteristic of this age group that predisposes to a greater risk of falls and fractures. Other factors that determine a greater risk in older subjects with obesity are chronic proinflammatory status, altered adipokine secretion, vitamin D deficiency, insulin resistance and reduced mobility.

762
08 May 2023

Topic Review

Surgically Resectable NSCLC

Early-stage NSCLC (stages I and II, and some IIIA diseases) accounts for approximately 30% of non-small cell lung cancer (NSCLC) cases, with surgery being its main treatment modality. The risk of disease recurrence and cancer-related death, however, remains high among NSCLC patients after complete surgical resection. In previous studies on the long-term follow-up of post-operative NSCLC, the results showed that the five-year survival rate was about 65% for stage IB and about 35% for stage IIIA diseases. Platinum-based chemotherapy with or without radiation therapy has been used as a neoadjuvant therapy or post-operative adjuvant therapy in NSCLC, but the improvement of survival is limited. Immune checkpoint inhibitors (ICIs) have effectively improved the 5-year survival of advanced NSCLC patients. Cancer vaccination has also been explored and used in the prevention of cancer or reducing disease recurrence in resected NSCLC.

756
07 Jul 2021

Topic Review

Different Parameters for the Diagnosis of Diabetes

Both immediate and lingering health issues are associated with diabetes mellitus. Therefore, it is crucial to find it at a very early stage. Recently, using implanted bioelectronics to assess physiological markers has been used as a therapeutic or diagnostic tool in medicine. Conditions include diabetes, diabetic foot, heart disease, kidney failure, and stroke can all cause death. Patients with early-stage diabetes may not exhibit any clinical symptoms, making it challenging to recognize them. Continuous blood glucose and urine monitoring are necessary in daily life for diabetes prevention and early treatment.

753
11 Apr 2023

Topic Review

Endoscopic Papillary Abnormalities and EPSR

The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions.

752
10 Aug 2021

Topic Review

Dyadic Developmental Psychotherapy

Dyadic developmental psychotherapy is a psychotherapeutic treatment method for families that have children with symptoms of emotional disorders, including complex trauma and disorders of attachment. It was originally developed by Daniel Hughes as an intervention for children whose emotional distress resulted from earlier separation from familiar caregivers. Hughes cites attachment theory and particularly the work of John Bowlby as theoretical motivations for dyadic developmental psychotherapy. Dyadic developmental therapy principally involves creating a "playful, accepting, curious, and empathic" environment in which the therapist attunes to the child's "subjective experiences" and reflects this back to the child by means of eye contact, facial expressions, gestures and movements, voice tone, timing and touch, "co-regulates" emotional affect and "co-constructs" an alternative autobiographical narrative with the child. Dyadic developmental psychotherapy also makes use of cognitive-behavioral strategies. The "dyad" referred to must eventually be the parent-child dyad. The active presence of the primary caregiver is preferred but not required. A study by Arthur Becker-Weidman in 2006, which suggested that dyadic developmental therapy is more effective than the "usual treatment methods" for reactive attachment disorder and complex trauma, has been criticised by the American Professional Society on the Abuse of Children (APSAC). According to the APSAC Taskforce Report and Reply, dyadic developmental psychotherapy does not meet the criteria for designation as "evidence based" nor provide a basis for conclusions about "usual treatment methods". A 2006 research synthesis described the approach as a "supported and acceptable" treatment, but this conclusion has also proved controversial. A 2013 review of research recommended caution about this method of therapy, arguing that it has "no support for claims of effectiveness at any level of evidence" and a questionable theoretical basis.

749
17 Nov 2022

Topic Review

Etiopathogenic Factors for Obesity

Obesity is an abnormal or excessive accumulation of fat that represents a health risk, and it is characterized by reaching a body mass index (BMI) equal to or greater than 30 kg/m2. Obesity is a chronic disease of multifactorial etiology that involves an energy imbalance, genetic and epigenetic factors, alterations in glucose and lipid metabolism, disorders of adipose tissue functioning, neuroendocrine dysregulation, and alterations in the intestinal microbiota, among others.

747
05 Mar 2024

Topic Review

Pathogenesis and Histopathology of Albuminuric and Non-Albuminuric DKD

Diabetic kidney disease (DKD) is a common microvascular complication that develops in approximately 40% of patients with diabetes. It is the main cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) and is a major cause of mortality and morbidity in diabetics not only due to ESRD but also because of the resulting cardiovascular risk.

742
18 May 2023

Topic Review Peer Reviewed

Diabetic Kidney Disease: Goals for Management, Prevention, and Awareness

Diabetic kidney disease (DKD), which is diagnosed on the basis of reduced glomerular filtration rate (GFR), increased albuminuria, or both, is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. Future projections anticipate a significant increase in diabetes cases, with close to 700 million diabetes patients internationally by the year 2045. Amidst ongoing research into novel biomarkers and therapeutic agents for DKD, the current clinical preventative strategy for DKD involves (1) intensive glycemic control, (2) treatment of associated co-morbidities (hypertension and hyperlipidemia), and (3) instruction on lifestyle modifications, including smoking cessation, exercise, and dietary habits. In addition to these three categories, patient education on renal injury, a fourth category, is equally important and necessary in the collaborative effort to reduce global rates of DKD. In this entry, authors highlight and discuss these four core categories for DKD prevention.

742
28 Sep 2023

Topic Review

Differential Diagnosis of Sensory and Cognitive Malingering

Malingering relates to intentionally pretending or exaggerating physical or psychologic symptoms to gain an external incentive, such as avoiding work, law prosecution or military service, or seeking financial compensation from insurance companies. Accordingly, various techniques have been developed in recent years by the scientific community to address this challenge.

739
31 Jul 2023

Topic Review

Redox Signaling Modulates Activity of Immune Checkpoint Inhibitors

Although immunotherapy is already a staple of cancer care, many patients may not benefit from these cutting-edge treatments. A crucial field of research now focuses on figuring out how to improve treatment efficacy and assess the resistance mechanisms underlying this uneven response. For a good response, immune-based treatments, in particular immune checkpoint inhibitors, rely on a strong infiltration of T cells into the tumour microenvironment. The severe metabolic environment that immune cells must endure can drastically reduce effector activity. These immune dysregulation-related tumour-mediated perturbations include oxidative stress, which can encourage lipid peroxidation, ER stress, and T regulatory cells dysfunction.

738
11 May 2023

Topic Review

Interplay between Thyroid Disorders and T2DM

Thyroid disorders (TD) and diabetes mellitus (DM) are the two endocrinopathies with the highest prevalence in the general population that frequently coexist. Thyroid dysfunction is more common in people with type 2 diabetes mellitus (T2DM) compared to normoglycemic individuals. Untreated TD can impair glycemic control, increasing the risk of diabetes complications. Hyperinsulinemia can affect the morphology of the thyroid gland by promoting the proliferation of thyroid tissue and increasing the size of thyroid nodules. Metformin can confer benefits in both endocrinopathies, while other antidiabetics, such as sulfonylureas, can negatively affect thyroid function.

738
23 Nov 2023

Topic Review

Genomics of Endometriosis

Endometriosis is a gynecologic disease affecting women of reproductive age. Its precise prevalence is in fact unknown, but classically estimated at around 10%. It is characterized by two major clinical manifestations: pain and infertility.

734
21 Jul 2021

Topic Review

Radioiodine-Refractory Thyroid Cancer

Recurrent, metastatic disease represents the most frequent cause of death for patients with thyroid cancer, and radioactive iodine (RAI) remains a mainstay of therapy for these patients. Unfortunately, many thyroid cancer patients have tumors that no longer trap iodine, and hence are refractory to RAI, heralding a poor prognosis. RAI-refractory (RAI-R) cancer cells result from the loss of thyroid differentiation features, such as iodide uptake and organification. This loss of differentiation features correlates with the degree of mitogen-activated protein kinase (MAPK) activation, which is higher in tumors with BRAF (B-Raf proto-oncogene) mutations than in those with RTK (receptor tyrosine kinase) or RAS (rat sarcoma) mutations. Hence, inhibition of the mitogen-activated protein kinase kinase-1 and -2 (MEK-1 and -2) downstream of RAF (rapidly accelerated fibrosarcoma) could sensitize RAI refractivity in thyroid cancer. However, a significant hurdle is the development of secondary tumor resistance (escape mechanisms) to these drugs through upregulation of tyrosine kinase receptors or another alternative signaling pathway. The sodium iodide symporter (NIS) is a plasma membrane glycoprotein, a member of solute carrier family 5A (SLC5A5), located on the basolateral surfaces of the thyroid follicular epithelial cells, which mediates active iodide transport into thyroid follicular cells.

734
22 Oct 2021

Topic Review

Insulin and Transcriptional Regulation of Lipid Metabolism

There is a wide variety of kinds of lipids, and complex structures which determine the diversity and complexity of their functions. With the basic characteristic of water insolubility, lipid molecules are independent of the genetic information composed by genes to proteins, which determine the particularity of lipids in the human body, with water as the basic environment and genes to proteins as the genetic system. After the well-studied PI3K-AKT pathway, insulin affects fat synthesis by controlling the activity and production of various transcription factors.

733
31 Oct 2022

Topic Review

Gallbladder Cancer Therapy

Gallbladder cancer (GBC) is the most common form of biliary tract cancer. It is characterized by unique pathogenetic and molecular features that differ from other biliary tract cancer forms (e.g., inflammation-based carcinogenesis and distinctive molecular alterations, strong association with female sex, and geographical clustering). Therefore, differentiated therapy is mandatory to improve patients’ outcome and survival, especially regarding characteristic molecular alterations that bare the opportunity for the use of new targeted therapeutics.

733
30 Nov 2022

Topic Review

Altered Pathways in Fabry Disease

Fabry disease is a rare X-linked disease characterized by deficient expression and activity of alpha-galactosidase A (α-GalA) with consequent lysosomal accumulation of glycosphingolipid in various organs. Enzyme replacement therapy is the cornerstone of the treatment of all Fabry patients, although in the long-term it fails to completely halt the disease’s progression. This suggests on one hand that the adverse outcomes cannot be justified only by the lysosomal accumulation of glycosphingolipids and on the other that additional therapies targeted at specific secondary mechanisms might contribute to halt the progression of cardiac, cerebrovascular, and renal disease that occur in Fabry patients.

733
15 Mar 2023

Topic Review

Sleep Disorders and Diabetic Foot

Diabetic foot is associated with a low quality of life since physical disabilities, mood disturbances and psychological disorders are frequent. One of the most important biological processes to ensure quality of life is sleep. Sleep disorders can impair glycemic control in patients with diabetes mellitus or even cause long-term type 2 diabetes mellitus.

727
05 Jul 2021

Topic Review

The Metabolomics

Metabolomics is a combined set of strategies to identify and quantify cellular metabolites using advanced analytical tools. This is typically achieved through the use of liquid or gas chromatography, which allows for the detection of individual metabolites through their specific mass-to-charge ratio (m/z) and their fragmentation in a mass spectrometer. By matching detected metabolites against databases of known metabolites, it is possible to identify the specific metabolites altered by exercise in a biological sample.

727
19 Jun 2023

Topic Review

Endothelial Dysfunction and Chronic Inflammation

Vascular diseases of the elderly are a topic of enormous interest in clinical practice, as they have great epidemiological significance and lead to ever-increasing healthcare expenditures. The mechanisms underlying these pathologies have been increasingly characterized. It has emerged that endothelial dysfunction and chronic inflammation play a diriment role among the most relevant pathophysiological mechanisms. As one can easily imagine, various processes occur during aging, and several pathways undergo irreversible alterations that can promote the decline and aberrations that trigger the diseases above. Endothelial dysfunction and aging of circulating and resident cells are the main characteristics of the aged organism; they represent the framework within which an enormous array of molecular abnormalities occur and contribute to accelerating and perpetuating the decline of organs and tissues.

724
31 Jan 2023

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