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Topic Review
Obstructive Sleep Apnea (OSA)
OSA is a major primary sleep disorder characterized by repetitive nocturnal complete (apnea) or partial (hypopnea), collapses of the upper airway during sleep accompanied by oxyhemoglobin desaturation and/or electroencephalography (EEG) and vegetative arousals. Nocturnal OSA symptoms include sleep fragmentation, diminished amounts of slow wave and rapid eye movement (REM) sleep, nocturia and insomnia. 
  • 1.0K
  • 29 Oct 2020
Topic Review
Obstructive Sleep Apnea
The aim of this study was to assess the current scientific data and to summarize systematically the evidence of efficiency of adenotonsillectomy (AT) and orthodontic treatment (i.e.: rapid maxillary expansion (RME) and mandibular advancement (MA)) in the treatment of pediatric OSA. AT and orthodontic treatment were more effective together than separately to cure OSA in pediatric patients. There was a higher decrease of Apnea Hypoapnea Index (AHI) and Respiratory Disturbance Index (RDI), a major increase of the lowest oxygen saturation and the oxygen desaturation index (ODI) after undergoing both treatments. Nevertheless, reappearance of OSA could occur several years after reporting adequate treatment. In order to avoid recurrence, myofunctional therapy (MT) could be recommended as follow-up. However, further studies with good clinical evidence are required to confirm this finding.
  • 1.0K
  • 18 Jan 2022
Topic Review
Diagnosis and Management of Achalasia
Achalasia is a rare neurodegenerative disorder causing dysphagia and is characterized by abnormal esophageal motor function as well as the loss of lower esophageal sphincter (LES) relaxation. The assessment and management of achalasia has significantly progressed in recent years due to the advances in high-resolution manometry (HRM) technology along with the improvements and innovations of therapeutic endoscopy procedures. The recent evolution of HRM technology with the inclusion of an adjunctive test, fluoroscopy, and EndoFLIP has enabled more precise diagnoses of achalasia to be made and the subgrouping into therapeutically meaningful subtypes.
  • 1.0K
  • 25 Aug 2021
Topic Review
The HSC Niche in β-thalassemia and SCD
Hemoglobinopathies are inherited disorders affecting hemoglobin (Hb) production, estimated to be the most common monogenic diseases worldwide. In the last decade, research on pathophysiology and therapeutic solutions for β-thalassemia (BThal) and sickle cell disease (SCD) has been mostly focused on the primary erythroid defect, thus neglecting the study of hematopoietic stem cells (HSCs) and bone marrow (BM) microenvironment. The quality and engraftment of HSCs depend on the BM microenvironment, influencing the outcome of HSC transplantation (HSCT) both in allogeneic and in autologous gene therapy settings. In BThal and SCD, the consequences of severe anemia alter erythropoiesis and cause chronic stress in different organs, including the BM. 
  • 1.0K
  • 07 Jul 2022
Topic Review
Individualized Hemodynamic Management in Sepsis
Hemodynamic optimization remains the cornerstone of resuscitation in the treatment of sepsis and septic shock. Delay or inadequate management will inevitably lead to hypoperfusion, tissue hypoxia or edema, and fluid overload, leading eventually to multiple organ failure, seriously affecting outcomes. According to a large international survey (FENICE study), physicians frequently use inadequate indices to guide fluid management in intensive care units. Goal-directed and “restrictive” infusion strategies have been recommended by guidelines over “liberal” approaches for several years. Unfortunately, these “fixed regimen” treatment protocols neglect the patient’s individual needs, and what is shown to be beneficial for a given population may not be so for the individual patient. However, applying multimodal, contextualized, and personalized management could potentially overcome this problem.
  • 1.0K
  • 12 Mar 2021
Topic Review
Airway Structural Changes in Asthma
Increased airway wall thickness and remodeling of bronchial mucosa are characteristic of asthma and may arise from altered integrin signaling on airway cells. Here, we analyzed the expression of β1-subfamily integrins on blood and airway cells (flow cytometry), inflammatory biomarkers in serum and bronchoalveolar lavage, reticular basement membrane (RBM) thickness and collagen deposits in the mucosa (histology), and airway geometry (CT-imaging) in 92 asthma patients (persistent airflow limitation subtype: n=47) and 36 controls. Persistent airflow limitation was associated with type-2 inflammation, elevated soluble α2 integrin chain, and changes in the bronchial wall geometry. Both subtypes of asthma showed thicker RBM than control, but collagen deposition and epithelial α1 and α2 integrins staining were similar. Type-I collagen accumulation and RBM thickness were inversely related to the epithelial expression of the α2 integrin chain. Expression of α2β1 integrin on T-cells and eosinophils was not altered in asthma. Collagen I deposits were, however, more abundant in patients with lower α2β1 integrin on blood and airway CD8+ T-cells. Thicker airway walls in CT were associated with lower α2 integrin chain on blood CD4+ T-cells and airway eosinophils. Our data suggest that α2β1 integrin on inflammatory and epithelial cells may protect against airway remodeling advancement in asthma.
  • 1.0K
  • 30 Sep 2021
Topic Review
Translation of Ferroptosis into Clinical Hepatocellular Carcinoma Practice
Ferroptosis, an iron and reactive oxygen species (ROS)-dependent non-apoptotic type of regulated cell death, is characterized by a massive iron overload and peroxidation of polyunsaturated fatty acids (PUFAs), which finally results in cell death. Recent studies suggest that ferroptosis can influence carcinogenesis negatively and therefore may be used as a novel anti-cancer strategy. Hepatocellular carcinoma (HCC) is a deadly malignancy with poor chances of survival and is the second leading cause of cancer deaths worldwide. Diagnosis at an already late stage and general resistance to current therapies may be responsible for the dismal outcome. As the liver acts as a key factor in iron metabolism, ferroptosis is shown to play an important role in HCC carcinogenesis and, more importantly, may hold the potential to eradicate HCC.
  • 1.0K
  • 05 May 2022
Topic Review
Hedgehog Signaling during Nerve Healing
The peripheral nervous has important regenerative capacities that regulate and restore peripheral nerve homeostasis. Following peripheral nerve injury, the nerve undergoes a highly regulated degeneration and regeneration process, called Wallerian degeneration, where numerous cell populations interact to allow proper nerve regeneration. Recent studies have evidenced the prominent role of morphogenetic Hedgehog signaling pathway and its main effectors, Sonic Hedgehog (SHH) and Desert Hedgehog (DHH) in the regenerative drive following nerve injury. Furthermore, dysfunctional regeneration and/or dysfunctional Hedgehog signaling participate in the development of chronic neuropathic pain that sometimes accompanies nerve healing in the clinical context. Understanding the implications of this key signaling pathway could provide exciting new perspectives for future research on peripheral nerve healing.  
  • 1.0K
  • 21 Dec 2020
Topic Review
Molecular Characterization of MTUT
Muellerian-type tumors of the urinary tract (MTUT) were implemented in the 2016 WHO classification as an entity comprising clear cell adenocarcinomas (CCAs) and endometrioid adenocarcinomas (EAs) of the bladder/urinary tract . The histologically clear cell tumors were initially described as mesonephric adenocarcinomas by Konnak in 1973 and re-named as clear cell adenocarcinomas in 1985 by Young and Scully.
  • 1.0K
  • 01 Jul 2021
Topic Review
Serotoninergic System in Brain Disorders
Serotonin (5-hydroxytryptamine, 5-HT) is a biogenic monoamine acting as a neurotransmitter in the central nervous system (CNS), local mediator in the gut, a mitogen factor, and vasoactive agent in the blood. It has been linked to a variety of CNS functions and is implicated in many CNS and psychiatric disorders. The high comorbidity between some neuropathies can be partially understood by the fact that these diseases share a common etiology involving the serotoninergic system. The developing CNS of fetus and newborn is particularly susceptible to environmental pollutants, and perinatal exposure could result in the later development of brain disorders.
  • 1.0K
  • 27 Oct 2021
Topic Review
Pathophysiology of TBI Associated Sleep Dysfunction
Traumatic brain injury (TBI) is one of the most prevalent causes of morbidity in the United States and is associated with numerous chronic sequelae long after the point of injury. One of the most common long-term complaints in patients with TBI is sleep dysfunction. It is reported that alterations in melatonin follow TBI and may be linked with various sleep and circadian disorders directly (via cellular signaling) or indirectly (via free radicals and inflammatory signaling). 
  • 1.0K
  • 27 Apr 2023
Topic Review
Vascular Smooth Muscle Cell Phenotype Switching in Arteriogenesis
Vascular smooth muscle cells in the adult vasculature are not terminally differentiated cells. They possess extensive plasticity such that it can be stimulated to undergo a structural and functional transition into proliferative/migratory/synthetic phenotype or undergo an extreme phenotypic change into osteochondrocyte-like cells, foam-like cells, and myofibroblastsas detected in atherosclerotic lesions. Nevertheless, SMC plasticity enables de-differentiated SMCs to re-differentiate back to a quiescent and contractile state according to their microenvironment. SMCs are the predominant cell type in collateral arteries that restores blood flow after significant arterial occlusion in peripheral arterial disease patients. They respond to altered blood flow and inflammatory conditions after an arterial occlusion by switching their phenotype between quiescent contractile and proliferative synthetic states.
  • 1.0K
  • 13 Feb 2023
Topic Review
Prevent and Treat Oral Mucositis
Oral Mucositis, a debilitating side effect of radio and chemotherapy for head and neck cancers, involves inflammation and ulceration of the mucous membranes in the oral cavity. This condition often leads to severe pain, difficulty in eating, and compromised quality of life for cancer patients. The use of natural compounds such as polyphenols has shown promise in preventing and alleviating Oral Mucositis as they possess anti-inflammatory, antioxidant, and healing properties, capable of mitigating the adverse effects of chemo and radiotherapy on the oral mucosa.
  • 1.0K
  • 12 Jan 2024
Topic Review
Neonatal Screening for MPS Disorders
Newborn screening enables the diagnosis of treatable disorders at the early stages, and because of its countless benefits, conditions have been continuously added to screening panels, allowing early intervention, aiming for the prevention of irreversible manifestations and even premature death. Mucopolysaccharidoses (MPS) are lysosomal storage disorders than can benefit from an early diagnosis, and thus are being recommended for newborn screening. They are multisystemic progressive disorders, with treatment options already available for several MPS types. MPS I was the first MPS disorder enrolled in the newborn screening (NBS) panel in the USA and a few other countries, and other MPS types are expected to be added. Very few studies about NBS for MPS in Latin America have been published so far.
  • 1.0K
  • 27 Nov 2020
Topic Review
Genetic Determinants in Severe Asthma
Asthma is a chronic respiratory disease usually characterized by inflammatory changes in the lower airways that requires long-term management.
  • 999
  • 28 Sep 2021
Topic Review
Exercise Mitigates Pathological Liver Changes
Exercise attenuates pathological changes in the liver induced by high-fat diets. The underlying mechanisms might be related to Nuclear factor erythroid-2-related factor 2 (NRF2) and mediated by SIRT1/AMPK signaling. 
  • 999
  • 29 Mar 2022
Topic Review
Endothelial Dysfunction in Diabetic Subjects
Endothelial Dysfunction is a condition of altered metabolism and function of endothelium inducing vascular injury and defective repair.
  • 997
  • 06 Jan 2021
Topic Review
Electronic Cigarettes
Electronic cigarettes (EC) are a novel product, marketed as an alternative to tobacco cigarette. Its effects on human health have not been investigated widely yet, especially in specific populations such as patients with asthma.
  • 996
  • 18 Aug 2021
Topic Review
EDCs and Prostate Disease
Endocrine-disrupting chemicals (EDCs) belong to a heterogeneous class of environmental pollutants widely diffused in different aquatic and terrestrial habitats. This implies that humans and animals are continuously exposed to EDCs from different matrices and sources. Moreover, pollution derived from anthropic and industrial activities leads to combined exposure to substances with multiple mechanisms of action on the endocrine system and correlated cell and tissue targets. For this reason, specific organs, such as the prostate gland, which physiologically are under the control of hormones like androgens and estrogens, are particularly sensitive to EDC stimulation. It is now well known that an imbalance in hormonal regulation can cause the onset of various prostate diseases, from benign prostate hyperplasia to prostate cancer.
  • 995
  • 21 Oct 2021
Topic Review
Immunohistochemistry in Liver Tumors Diagnosis
Although radiological diagnostics have been progressing, pathological diagnosis remains the most reliable method for diagnosing liver tumors. In some cases, definite pathological diagnosis cannot be obtained by histological evaluation alone, especially when the sample is a small biopsy; in such cases, immunohistochemical staining is very useful. Immunohistochemistry is the most frequently used technique for molecular pathological diagnosis due to its broad application, ease of performance and evaluation, and reasonable cost. The results occasionally reflect specific genetic mutations. The immunohistochemical markers of hepatocellular carcinoma include those of hepatocellular differentiation—such as hepatocyte paraffin 1 and arginase-1—and those of malignant hepatocytes—such as glypican-3, heat shock protein 70, and glutamine synthetase (GS). To classify the subtypes of hepatocellular adenoma, examination of several immunohistochemical markers, such as liver fatty acid-binding protein, GS, and serum amyloid A, is indispensable. Immunohistochemical staining for GS is also important for the diagnosis of focal nodular hyperplasia. The representative immunohistochemical markers of intrahepatic cholangiocarcinoma include cytokeratin (CK) 7 and CK19.
  • 993
  • 15 Jun 2021
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