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Topic Review
Integrated Diagnostics of Thyroid Nodules
Thyroid nodules are commonly detected in daily clinical practice, and their diagnosis and therapy usually involve different specialists and various diagnostic and therapeutic methods. Thyroid nodule management requires the integration of laboratory, imaging, and pathology examinations to achieve a proper diagnosis. It enables the elimination of unnecessary therapeutic procedures in many individuals and the timely identification of patients who require specific therapies. Furthermore, bioinformatics may change the current management of clinical data, enabling more personalized diagnostic approaches for patients with thyroid nodules.
  • 957
  • 16 Jan 2024
Topic Review
Head and Neck Squamous-Cell-Carcinoma
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer arising in the head and neck region. The most common risk factors are smoking, excessive drinking, and human papillomavirus (HPV) infection. 
  • 956
  • 05 Feb 2021
Topic Review
Factitious Disorder
A factitious disorder is a condition in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain (for themselves or for another) a patient's role. People with a factitious disorder may produce symptoms by contaminating urine samples, taking hallucinogens, injecting fecal material to produce abscesses, and similar behaviour. Factitious disorder imposed on self (also called Munchausen syndrome) was for some time the umbrella term for all such disorders. Factitious disorder imposed on another (also called Munchausen syndrome by proxy, Munchausen by proxy, or factitious disorder by proxy) is a condition in which a person deliberately produces, feigns, or exaggerates the symptoms of someone in their care. In either case, the perpetrator's motive is to perpetrate factitious disorders, either as a patient or by proxy as a caregiver, in order to attain (for themselves or for another) a patient's role. Malingering differs fundamentally from factitious disorders in that the malingerer simulates illness intending to obtain a material benefit or avoid an obligation or responsibility. Somatic symptom disorders, though also diagnoses of exclusion, are characterized by physical complaints that are not produced intentionally.
  • 956
  • 19 Oct 2022
Topic Review
PPARs in the Fetal Origins of Adult Disease
The fetal origins of adult disease (FOAD) hypothesis holds that events during early development have a profound impact on one’s risk for the development of future adult disease. Studies from humans and animals have demonstrated that many diseases can begin in childhood and are caused by a variety of early life traumas, including maternal malnutrition, maternal disease conditions, lifestyle changes, exposure to toxins/chemicals, improper medication during pregnancy, and so on. Recently, the roles of Peroxisome proliferator-activated receptors (PPARs) in FOAD have been increasingly appreciated due to their wide variety of biological actions. PPARs are members of the nuclear hormone receptor subfamily, consisting of three distinct subtypes: PPARα, β/δ, and γ, highly expressed in the reproductive tissues.
  • 956
  • 17 Nov 2022
Topic Review
Hyperuricemia and Gout
Hyperuricemia is a risk factor for gout. It has been well observed that a large proportion of individuals with hyperuricemia have never had a gout flare(s), while some patients with gout can have a normuricemia. This raises a puzzle of the real role of serum uric acid (SUA) in the occurrence of gout flares. As the molecule of uric acid has its dual effects in vivo with antioxidant properties as well as being an inflammatory promoter, it has been placed in a delicate position in balancing metabolisms. Gout seems to be a multifactorial metabolic disease and its pathogenesis should not rely solely on hyperuricemia or monosodium urate (MSU) crystals. 
  • 955
  • 22 Mar 2021
Topic Review
Lipid Metabolism and Homeostasis in Neuroendocrine Neoplasms
Lipid metabolism is known to be involved in tumorigenesis and disease progression in many common cancer types, including colon, lung, breast and prostate, through modifications of lipid synthesis, storage and catabolism. Furthermore, lipid alterations may arise as a consequence of cancer treatment and may have a role in treatment resistance. Neuroendocrine neoplasms (NENs) are a heterogeneous group of malignancies with increasing incidence, whose mechanisms of cancer initiation and progression are far from being fully understood. Alterations of lipid metabolism may be common across various cancer types.
  • 953
  • 09 Dec 2022
Topic Review
Chalcones with Anticancer Activity
Chalcones of natural origin present a pattern of phenolic hydroxyls that originate from the biosynthetic reactions of flavonoids. 
  • 953
  • 17 May 2023
Topic Review
Type 1 Diabetes Mellitus
Patients with type 1 diabetes mellitus (T1DM) present elevated levels of cytokines including interleukin-1a (IL), IL-1β, IL-2, IL-6 and tumor necrosis factor alpha (TNF-α), suggesting the pre-existence of chronic inflammation, which, in turn, has been considered the major risk factor of adverse COVID-19 outcomes in many cohorts. Even more importantly, oxidative stress is a key player in COVID-19 pathogenesis and determines disease severity. It is well-known that extreme glucose excursions, the prominent feature of T1DM, are a potent mediator of oxidative stress through several pathways including the activation of protein kinase C (PKC) and the increased production of advanced glycation end products (AGEs). Additionally, chronic endothelial dysfunction and the hypercoagulant state observed in T1DM, in combination with the direct damage of endothelial cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may result in endothelial and microcirculation impairment, which contribute to the pathogenesis of acute respiratory syndrome and multi-organ failure. The binding of SARS-CoV-2 to angiotensin converting enzyme 2 (ACE2) receptors in pancreatic b-cells permits the direct destruction of b-cells, which contributes to the development of new-onset diabetes and the induction of diabetic ketoacidosis (DKA) in patients with T1DM. Large clinical studies are required to clarify the exact pathways through which T1DM results in worse COVID-19 outcomes. 
  • 949
  • 19 May 2021
Topic Review
Heart Arrhythmia
Heart arrhythmia (also known as arrhythmia, dysrhythmia, or irregular heartbeat) is a group of conditions in which the heartbeat is irregular, too fast, or too slow. A heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia and a heart rate that is too slow – below 60 beats per minute – is called bradycardia. Many types of arrhythmia have no symptoms. When symptoms are present these may include palpitations or feeling a pause between heartbeats. In more serious cases there may be lightheadedness, passing out, shortness of breath, or chest pain. While most types of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in cardiac arrest. There are four main types of arrhythmia: extra beats, supraventricular tachycardias, ventricular arrhythmias, and bradyarrhythmias. Extra beats include premature atrial contractions, premature ventricular contractions, and premature junctional contractions. Supraventricular tachycardias include atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia. Ventricular arrhythmias include ventricular fibrillation and ventricular tachycardia. Arrhythmias are due to problems with the electrical conduction system of the heart. Arrhythmias may occur in children; however, the normal range for the heart rate is different and depends on age. A number of tests can help with diagnosis including an electrocardiogram (ECG) and Holter monitor. Most arrhythmias can be effectively treated. Treatments may include medications, medical procedures such as inserting a pacemaker, and surgery. Medications for a fast heart rate may include beta blockers or agents that attempt to restore a normal heart rhythm such as procainamide. This latter group may have more significant side effects especially if taken for a long period of time. Pacemakers are often used for slow heart rates. Those with an irregular heartbeat are often treated with blood thinners to reduce the risk of complications. Those who have severe symptoms from an arrhythmia may receive urgent treatment with a controlled electric shock in the form of cardioversion or defibrillation. Arrhythmia affects millions of people. In Europe and North America, as of 2014, atrial fibrillation affects about 2% to 3% of the population. Atrial fibrillation and atrial flutter resulted in 112,000 deaths in 2013, up from 29,000 in 1990. Sudden cardiac death is the cause of about half of deaths due to cardiovascular disease or about 15% of all deaths globally. About 80% of sudden cardiac death is the result of ventricular arrhythmias. Arrhythmias may occur at any age but are more common among older people.
  • 949
  • 08 Oct 2022
Topic Review
Cerato-Platanins from Marine Fungi
Marine Fungi can produce many interesting secondary metabolites, making them attractive in different application fields. In the presence of crude oil in the environment, many microorganisms are able to activate their metabolism to use hydrocarbons as sole carbon source, increasing the bioavailability of these compounds through the production of biosurfactants. Two groups of fungal small, secreted cysteine-rich proteins can act as good biosurfactant, hydrophobins (HFB) and Cerato-platanins (CP). HFBs are self-assembling proteins typical of filamentous fungi, described as the most powerful surface-active proteins. They are small  amphiphilic proteins that play multiple biological roles in fungal biology, lowering the surface tension of the liquid medium in their soluble form and coating fungal aerial structures. CPs are small, conserved, hydrophobic proteins, whose function is still a matter of debate. They can act both as virulence factor and as elicitors, and are able to weaken cellulose substrate, disrupting its non-covalent bonds without any hydrolytic activity. Similar to HFBs, their solutions lead to strong foam formation and they self-assemble at hydrophobic:hydrophilic interfaces into ordered, amphipathic layers. CPs, secreted by marine fungi grown on oil as sole carbon source, possess both surfactant and emulsifying activities, showing good performance in reducing surface tension and stabilizing emulsions.
  • 945
  • 29 Oct 2020
Topic Review
Middle-Aged Total Knee Replacement
An increasing number of total knee replacements (TKRs) are being performed in response to the growing burden of osteoarthritis. Patients <65 years of age represent the fastest growing group of TKR recipients, and are expected to account for an increasing number of primary and revision procedures. Concerns have been raised about the outcomes that can be expected by this age demographic who are more active, physically demanding, and have longer life expectancies compared to older TKR recipients. This systematic review and meta-analysis evaluated the effectiveness of TKR for osteoarthritis in patients < 65 years of age, compared to older individuals. The increasing use of TKR in patients < 65 years of age may be supported by a large degree of clinically meaningful improvements in patient-reported pain, function, and quality of life outcomes, and the majority of these patients are satisfied with their surgery. However, results into the second postoperative decade remain uncertain, with data suggesting a high prevalence of pain and increasing functional decline. Limited evidence suggests younger patients achieved generally equivalent and potentially greater improvements in patient-reported outcomes compared to older individuals following TKR for osteoarthritis.
  • 942
  • 18 Nov 2020
Topic Review
Expression of SARS-CoV-2 Entry Genes
To address the expression pattern of the SARS-CoV-2 receptor ACE2 and the viral priming protease TMPRSS2 in the respiratory tract, this study investigated RNA sequencing transcriptome profiling of samples of airway and oral mucosa. As shown, ACE2 has medium levels of expression in both small airway epithelium and masticatory mucosa, and high levels of expression in nasal epithelium. TMPRSS2 is highly expressed in small airway epithelium and nasal epithelium and has lower expression in masticatory mucosa. These results provide the molecular basis that the nasal mucosa is the most susceptible locus in the respiratory tract for SARS-CoV-2 infection.
  • 940
  • 25 Oct 2020
Topic Review
Mycobacterium tuberculosis and HIV-1: Evolution
This entry reviews the genetic evolution and adaptation to the host environment of M. tuberculosis and HIV-1. It provides an overview of the latest developments in the knowledge about the genetic diversity of these devastating intracellular human pathogens and its impact on the host immune system, virulence, drug resistance propensity and other relevant aspects. We also proposed a novel topic in the literature regarding the use of single cell "omics" to study the interacting evolutionary dynamics of M. tuberculosis and HIV-1 in co-infection, at the cellular niche of monocytes/macrophages.
  • 940
  • 20 Jan 2021
Topic Review
Prenatal Diagnosis of Cornelia de Lange syndrome
Cornelia de Lange syndrome (CDLS) is caused by pathogenic variants in genes which are structural or regulatory components of the cohesin complex. The classical Cornelia de Lange (CDLS) phenotype is characterized by distinctive facial features, growth retardation, upper limb reduction defects, hirsutism, and developmental delay. Non-classical phenotypes make this condition heterogeneous. 
  • 939
  • 17 Jan 2022
Topic Review
Mycobacterium Tuberculosis Infection
Mycobacterium tuberculosis (MTB) infection is characterized by granulomatous lung lesions and systemic inflammatory responses during active disease. Inflammasome activation is involved in regulation of inflammation. Inflammasomes are multiprotein complexes serving a platform for activation of caspase-1, which cleaves the proinflammatory cytokines such as interleukin-1β (IL-1β) and IL-18 into their active forms. These cytokines play an essential role in MTB control. MTB infection triggers activation of the nucleotide-binding domain, leucine-rich-repeat containing family, pyrin domain-containing 3 (NLRP3) and absent in melanoma 2 (AIM2) inflammasomes in vitro, but only AIM2 and apoptosis-associated speck-like protein containing a caspase-activation recruitment domain (ASC), rather than NLRP3 or caspase-1, favor host survival and restriction of mycobacterial replication in vivo. Interferons (IFNs) inhibits MTB-induced inflammasome activation and IL-1 signaling.
  • 935
  • 23 Feb 2021
Topic Review
Wound Infection
Wound infection is traditionally defined primarily by visual clinical signs, and secondarily by microbiological analysis of wound samples.
  • 935
  • 09 Nov 2022
Topic Review
Implantable Cardioverter-Defibrillator
An implantable cardioverter-defibrillator (ICD) or automated implantable cardioverter defibrillator (AICD) is a device implantable inside the body, able to perform cardioversion, defibrillation, and (in modern versions) pacing of the heart. The device is therefore capable of correcting most life-threatening cardiac arrhythmias. The ICD is the first-line treatment and prophylactic therapy for patients at risk for sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. Current devices can be programmed to detect abnormal heart rhythms and deliver therapy via programmable antitachycardia pacing in addition to low-energy and high-energy shocks. "AICD" was trademarked by the Boston Scientific corporation, so the more generic "ICD" is preferred terminology. Current device batteries last about six to ten years; with advances in technology (batteries with more capacity or potentially rechargeable batteries) it may be possible to increase this well past ten years. The lead (the electrical cable connecting the device to the heart) has a much longer average longevity but can incur various types of malfunction, specifically insulation failure or fracture of the conductor, and require replacement. The process of implantation of an ICD system is similar to implantation of a pacemaker. In fact, ICDs are composed of an ICD generator and of wires. The first component or generator contains a computer chip or circuitry with RAM (memory), programmable software, a capacitor and a battery; this is implanted typically under the skin in the left upper chest. The second part of the system is an electrode wire or wires that, similar to pacemakers, are connected to the generator and passed through a vein to the right chambers of the heart. The lead usually lodges in the apex or septum of the right ventricle. Just like pacemakers, ICDs can have a single wire or lead in the heart (in the right ventricle, single chamber ICD), two leads (in the right atrium and right ventricle, dual chamber ICD) or three leads (biventricular ICD, one in the right atrium, one in the right ventricle and one on the outer wall of the left ventricle). The difference between pacemakers and ICDs is that pacemakers are also available as temporary units and are generally designed to correct slow heart rates, i.e. bradycardia, while ICDs are often permanent safeguards against sudden life-threatening arrhythmias. Recent developments include the subcutaneous ICD (S-ICD), and the ability to pace the left ventricle from multiple sites near-simultaneously with Multipoint Pacing (Abbott).
  • 932
  • 05 Dec 2022
Topic Review
Medicines Management
Medicines management, as the handling of medications and medicinal products by healthcare professionals, consists of prescribing, dispensing, distributing, administration, patient education, follow up and monitoring, and is regulated by law.
  • 931
  • 01 Feb 2021
Topic Review
Allergic Rhinitis
Nasal obstruction is a frequent disorder that interferes with the daily patient’s quality of life. The key element in the pathophysiology of the disorder is the inferior turbinate hypertrophy related to multiple conditions such as allergic rhinitis (AR). Many patients are managed using conventional drug therapies such as antihistamines, decongestants, and intranasal steroid sprays, anticholinergic agents, mast cell stabilizers, and desensitizing vaccines. When traditional therapy failed to relieve AR symptoms, surgical inferior turbinate reduction (ITR) is indicated. A vast variety of surgical techniques have been reported in the literature for AR such as resectioning, coagulating, and laser procedures.
  • 931
  • 05 Aug 2021
Topic Review
Laxaphycins
Laxaphycins were first isolated by Moore’s Hawaiian group in 1992. They were extracted from the cyanobacterium Anabaena laxa, collected in mud on the campus of the University of Hawaii.
  • 929
  • 30 Sep 2021
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