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Topic Review
Peripheral Arterial Disease
Peripheral arterial disease (PAD) is a pathological condition in which the blood supply to peripheral tissues is inadequate as a result of arterial dysfunction. 95% of PAD cases are caused by atherosclerosis, and 5% are due to vasculitis, genetic causes, and consequences of trauma. The main symptom of PAD is intermittent claudication. The most important test for the diagnosis of PAD is the measurement of the ankle-brachial index (ABI), which is the ratio of systolic blood pressure measured at the ankle to systolic blood pressure measured at the upper arm. A value below 0.9 is considered a criterion for the diagnosis of PAD. Due to increased vascular stiffness, PAD may be overstated in patients with diabetes.
  • 909
  • 30 Jun 2021
Topic Review
Uric Acid in Heart Failure
UA is an independent predictor of mortality in acute and chronic HF, making it a significant prognostic factor in both settings. High serum levels have been also associated with an increased incidence of HF, thus expanding the clinical utility of UA. 
  • 909
  • 20 Feb 2021
Topic Review
Symptom Targeted Intervention
Symptom targeted intervention (STI) is a clinical program being used in medical settings to help patients who struggle with symptoms of depression or anxiety or adherence to treatment plans but who are not interested in receiving outpatient mental health treatment. STI is an individualized therapeutic model and clinical program that teaches patients brief, effective ways to cope with difficult thoughts, feelings, and behaviors using evidence-based interventions. Its individualized engagement process employs techniques from solution-focused therapy, using a Rogerian, patient-centered philosophy. This engagement process ensures that even challenging, at-risk, and non-adherent patients are able to participate. Social workers and other mental health practitioners and medical professionals use STI to assist patients with a number of specific concerns, from sleep and stress to pain management, relationships and mood management. STI's coping tools are cognitive behavioral therapy and mindfulness interventions that have been condensed and modified to make them user friendly and effective in brief sessions. After meeting with the clinician, the patient takes charge, performing interventions at home through assignments that extend and reinforce learning. Using STI, the clinician helps the patient identify the most problematic symptom of the depression (such as depressed mood, insomnia, anxiety, rumination, irritability, negative thinking, social isolation), then together the clinician and patient address that symptom using STI's evidence-based selection of brief cognitive, behavioral, and mindfulness techniques. The emphasis is on keeping interactions brief since mental health treatment in the primary care setting is typically time limited—although the Collaborative Care and Integrated Care models provides hope for improved and expanded mental health services in the primary care setting. As patients learn better coping skills, they become more engaged with their treatment and more adherent to doctors’ recommendations. STI also gives social workers ways to uncover their clinical strengths and tools to continue to work with resistant patients. With STI training, clinicians learn a nuanced approach to all patients, even those who resist help, since often those are the individuals who need help most. After learning STI, clinicians report that they are more likely to approach rather than avoid difficult patient situations.
  • 909
  • 30 Nov 2022
Topic Review
Osteoporosis and Environmental Substances
Osteoporosis is a disease having adverse effects on bone health and causing fragility fractures. Osteoporosis affects approximately 200 million people worldwide, and nearly 9 million fractures occur annually. Evidence exists that, in addition to traditional risk factors, certain environmental substances may increase the risk of osteoporosis.
  • 906
  • 09 Mar 2021
Topic Review
Somatostatin Receptor Ligands in Clinical Management of Acromegaly
Somatostatin receptor ligands (SRLs) represent a true milestone in the medical therapy for acromegaly. The first-generation SRLs (FG-SRLs), octreotide and lanreotide, have demonstrated good efficacy in disease control and tumor shrinkage, and are still considered first-line medical therapies. The development of long-acting release (LAR) formulations has certainly improved the therapeutic tolerability of these drugs.  In the case of FG-SRL-resistant disease, pasireotide, the only second generation SRL currently available, demonstrated superiority in disease control and tumor shrinkage compared to FG-SRLs. However, its use in clinical practice is still limited due to concern for impairment in glucose homeostasis.
  • 906
  • 21 Jul 2022
Topic Review
Exposome and Asthma
Asthma is a widespread respiratory disease caused by complex contribution from genetic, environmental and behavioral factors. For several decades, its sensitivity to environmental factors has been investigated in single exposure (or single family of exposures) studies, which might be a narrow approach to tackle the etiology of such a complex multifactorial disease. The emergence of the exposome concept, introduced by C. Wild (2005), offers an alternative to address exposure–health associations. 
  • 905
  • 16 Feb 2021
Topic Review
mGluR1-PKCγ in the Pathogenesis of Spinocerebellar Ataxias
Spinocerebellar ataxias (SCAs) are a heterogeneous group of autosomal dominantly inherited progressive disorders with degeneration and dysfunction of the cerebellum. The genetic background of SCAs can be classified into two groups: Group I representing repeat expansion SCAs, such as SCA1 and SCA2 which are caused by dynamic repeat expansion mutations, typically polyglutamine repeat expansions, and Group II representing conventional mutation SCAs (non-repeat expansion SCAs), which are caused by nonsense mutations, missense mutations, deletions or insertions, such as SCA5 or SCA14. 
  • 905
  • 14 Sep 2022
Topic Review
On Ancient Medicine
The treatise On Ancient Medicine (Greek: Περὶ Ἀρχαίας Ἰατρικῆς; Latin: De vetere medicina) is perhaps the most intriguing and compelling work of the Hippocratic Corpus. The Corpus itself is a collection of about sixty writings covering all areas of medical thought and practice. Traditionally associated with Hippocrates, (c. 460 BC – c. 370 BC) the father of Western medicine, philological evidence now suggests that it was written over a period of several centuries and stylistically seems to indicate that it was the product of many authors dating from about 450-400 B.C.
  • 905
  • 23 Nov 2022
Topic Review
Adaptive Clinical Trial
An adaptive clinical trial is a dynamic clinical trial that evaluates a medical device or treatment by observing participant outcomes (and possibly other measures, such as side-effects) on a prescribed schedule, and, uniquely, modifying parameters of the trial protocol in accord with those observations. This is in contrast to traditional randomized clinical trials (RCTs) that are static in their protocol and do not modify any parameters until the trial is completed. The adaptation process generally continues throughout the trial, as prescribed in the trial protocol. Adaptions may include modifications to: dosage, sample size, drug undergoing trial, patient selection criteria and/or "cocktail" mix. In some cases, trials have become an ongoing process that regularly adds and drops therapies and patient groups as more information is gained. Importantly, the trial protocol is set before the trial begins which pre-specifies the adaptation schedule and processes.
  • 901
  • 30 Nov 2022
Topic Review
Intermittent Explosive Disorder
Intermittent explosive disorder (sometimes abbreviated as IED) is a behavioral disorder characterized by explosive outbursts of anger and/or violence, often to the point of rage, that are disproportionate to the situation at hand (e.g., impulsive shouting, screaming or excessive reprimanding triggered by relatively inconsequential events). Impulsive aggression is not premeditated, and is defined by a disproportionate reaction to any provocation, real or perceived. Some individuals have reported affective changes prior to an outburst, such as tension, mood changes, energy changes, etc. The disorder is currently categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under the "Disruptive, Impulse-Control, and Conduct Disorders" category. The disorder itself is not easily characterized and often exhibits comorbidity with other mood disorders, particularly bipolar disorder. Individuals diagnosed with IED report their outbursts as being brief (lasting less than an hour), with a variety of bodily symptoms (sweating, stuttering, chest tightness, twitching, palpitations) reported by a third of one sample. Aggressive acts are frequently reported accompanied by a sensation of relief and in some cases pleasure, but often followed by later remorse.
  • 899
  • 01 Dec 2022
Topic Review
Nerve Growth Factor and Autoimmune Diseases
Nerve growth factor (NGF) plays a crucial immunomodulatory role and increased levels are found in numerous tissues during autoimmune states. NGF directly modulates innate and adaptive immune responses of B and T cells and causes the release of neuropeptides and neurotransmitters controlling the immune system activation in inflamed tissues. Evidence suggests that NGF is involved in the pathogenesis of numerous immune diseases including autoimmune thyroiditis, chronic arthritis, multiple sclerosis, systemic lupus erythematosus, mastocytosis, and chronic granulomatous disease. Furthermore, as NGF levels have been linked to disease severity, it could be considered an optimal early biomarker to identify therapeutic approach efficacy. In conclusion, by gaining insights into how these molecules function and which cells they interact with, future studies can devise targeted therapies to address various neurological, immunological, and other disorders more effectively. This knowledge may pave the way for innovative treatments based on NGF manipulation aimed at improving the quality of life for individuals affected by diseases involving neurotrophins.
  • 896
  • 16 Nov 2023
Topic Review
Steroidal Saponins
Cancer is a global health burden responsible for an exponentially growing number of incidences and mortalities, regardless of the significant advances in its treatment. The identification of the hallmarks of cancer is a major milestone in understanding the mechanisms that drive cancer initiation, development, and progression. The hallmarks of cancer have been targeted to effectively treat various types of cancers. These conventional cancer drugs have shown significant therapeutic efficacy but continue to impose unfavorable side effects on patients. Naturally derived compounds are being tested in the search for alternative anti-cancer drugs. Steroidal saponins are a group of naturally occurring compounds that primarily exist as secondary metabolites in plant species. Studies have suggested that steroidal saponins possess significant anti-cancer capabilities. 
  • 893
  • 18 Aug 2023
Topic Review
Obesity and Asthma in Adults/Children
Obesity increases the risk of developing asthma in children and adults. Obesity is associated with different effects on lung function in children and adults. In adults, obesity has been associated with reduced lung function resulting from a relatively small effect on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), with the FEV1/FVC ratio remaining unchanged or mildly increased (restrictive pattern). In contrast, in children, obesity is associated with normal or higher FEV1 and FVC but a lower FEV1/FVC ratio (obstructive pattern). This anomaly has recently been associated with a phenomenon known as dysanapsis which results from a disproportionate growth between lung parenchyma size and airway calibre. The mechanisms that promote disproportionate lung parenchyma growth compared with airways in obese children remain to be elucidated. Obesity and dysanapsis in asthma patients might contribute to asthma morbidity by increasing airway obstruction, airway hyper-reactivity and airway inflammation. Obesity and dysanapsis in asthma patients are associated with increased medication use, more emergency department visits, hospitalizations and systemic corticosteroid burst than patients with normal weight. Dysanapsis may explain the reduced response to asthma medications in obese children. Weight loss results in a significant improvement in lung function, airway reactivity and asthma control.
  • 892
  • 27 Dec 2020
Topic Review
Derma-Hc
Atopic dermatitis (AD) is a chronic cutaneous disorder that is characterized by severe eczematous inflammation, swelling, and lichenification. Activation of T helper (Th)-22 cells by allergens leads to epidermal hyperplasia with hyperkeratosis at the chronic phase of AD. Derma-Hc is composed of five natural herbs with anti-AD effects, such as Astragalus membranaceus BUNGE, Schizonepeta tenuifolia Briq., Cryptotympana pustulata Fabr., Angelica sinensis Diels, Arctium lappa L. In this study, the ameliorative effect of Derma-Hc on cutaneous lichenification in 2,4-dinitrochlorobenzne (DNCB)-induced AD was investigated. The dorsal skin of mice was sensitized with DNCB to induce AD-like skin lesions. The dermatitis score and frequency of scratching were evaluated. Thickness of epidermis and dermis was measured by staining with H&E. In addition, infiltration of the mast cell was observed by staining with toluidine blue. Then, desmosomal cadherin, DSC1 was examined by immunofluorescence. Pathological mechanisms involved in lichenification were analyzed in AD-like skin lesions and TNF-α + IFN-γ-treated with human keratinocytes including keratinocyte differentiation genes and JAK1-STAT3 signaling pathway with IL-22 by RT-PCR and western blotting. Topical treatment of Derma-Hc improved AD-like symptoms such as dryness, edema and lichenefication and decreased the number of scratches. Histopathological analysis demonstrated that Derma-Hc significantly inhibited epidermal hyperplasia, hyperkeratosis, and mast cells infiltration. 
  • 890
  • 22 Sep 2021
Topic Review
Primary Hypertrophic Osteoathropathy
Pachydermoperiostosis (PDP) or primary hypertrophic osteoarthropathy (PHO) is a rare genetic disorder that affects both bones and skin. Other names are idiopathic hypertrophic osteoarthropathy or Touraine-Solente-Golé syndrome. It is mainly characterized by pachydermia (thickening of the skin), periostosis (excessive bone formation) and finger clubbing (swelling of tissue with loss of normal angle between nail and nail bed). This disease affects relatively more men than women. After onset, the disease stabilizes after about 5–20 years. Life of PDP patients can be severely impaired. Currently, symptomatic treatments are NSAIDs and steroids or surgical procedures. In 1868, PDP was first described by Friedreich as ‘excessive growth of bone of the entire skeleton’. Touraine, Solente and Golé described PDP as the primary form of bone disease hypertrophic osteoarthropathy in 1935 and distinguished its three known forms.
  • 890
  • 03 Nov 2022
Topic Review
Neonatal Hypoxic-Ischemic Brain Injury
Neonatal hypoxic-ischemic (HI) brain injury is one of the major drawbacks of mortality and causes significant short/long-term neurological dysfunction in newborn infants worldwide. To date, due to multifunctional complex mechanisms of brain injury, there is no well-established effective strategy to completely provide neuroprotection. Although therapeutic hypothermia is the proven treatment for hypoxic-ischemic encephalopathy (HIE), it does not completely chang outcomes in severe forms of HIE. Therefore, there is a critical need for reviewing the effective therapeutic strategies to explore the protective agents and methods. In recent years, it is widely believed that there are neuroprotective possibilities of natural compounds extracted from plants against HIE. These natural agents with the anti-inflammatory, anti-oxidative, anti-apoptotic, and neurofunctional regulatory properties exhibit preventive or therapeutic effects against experimental neonatal HI brain damage.
  • 889
  • 20 Jan 2021
Topic Review
Gene Therapy for Choroideremia
Choroideremia (CHM) is an X-linked recessive chorioretinal dystrophy caused by mutations involving the CHM gene. Gene therapy has entered late-phase clinical trials, although there have been variable results.
  • 886
  • 26 Jan 2021
Topic Review
Human Placenta Modeling
The human placenta brings the maternal and fetal circulatory systems into contact while keeping them independent, due to its intricate structure and adaptation in pregnancy. The placental barrier, composed essentially of trophoblasts, connective tissue and endothelium, separates the fetal and maternal compartments and is a key structure for this organ’s function. Maternal—fetal exchange takes place in the areas where the barrier is an extremely thin membrane (only 3.5 μm thick). Many of the human placental barrier functions are little understood and more representative models are still needed to better recapitulate the complex architecture and dynamics of the human fetal—placental barrier and provide a more in-depth understanding of the organ’s function.
  • 886
  • 16 Aug 2021
Topic Review
Congestive Hepatopathy
Liver disease resulting from heart failure (HF) has generally been referred as “cardiac hepatopathy”. One of its main forms is congestive hepatopathy (CH), which results from passive venous congestion in the setting of chronic right-sided HF. The current spectrum of CH differs from earlier reports with HF, due to ischemic cardiomyopathy and congenital heart disease having surpassed rheumatic valvular disease. The chronic passive congestion leads to sinusoidal hypertension, centrilobular fibrosis, and ultimately, cirrhosis (“cardiac cirrhosis”) and hepatocellular carcinoma after several decades of ongoing injury. Contrary to primary liver diseases, in CH, inflammation seems to play no role in the progression of liver fibrosis, bridging fibrosis occurs between central veins to produce a “reversed lobulation” pattern and the performance of non-invasive diagnostic tests of liver fibrosis is poor. Although the clinical picture and prognosis is usually dominated by the underlying heart condition, the improved long-term survival of cardiac patients due to advances in medical and surgical treatments are responsible for the increased number of liver complications in this setting. Eventually, liver disease could become as clinically relevant as cardiac disease and further complicate its management.
  • 885
  • 17 Dec 2020
Topic Review
International Epidemiological Association
The International Epidemiological Association (IEA) is a worldwide association with more than 2000 members in over 100 different countries, who follow the aims of the association to facilitate communication amongst those engaged in research and teaching of epidemiology throughout the world, and to encourage its use in all fields of health including social, community and preventative medicine. These aims are achieved by holding scientific meetings and seminars, by publication of journals, reports, translations of books, by contact amongst members and by other activities consistent with these aims. Members are accepted without regard to race, religion, sex, political affiliation or country of origin. The association publishes its own Journal, the International Journal of Epidemiology (IJE) , which is published bi-monthly, a complimentary copy of which is included in the membership dues. It also sponsors a number of highly reputable publications such as A Dictionary of Epidemiology, and The Development of Modern Epidemiology . In addition, the association organizes The World Congress of Epidemiology (WCE) which is held triennially in different parts of the world. The 19th WCE was held in Edinburgh, Scotland, August 2011, while the 20th WCE will be held in Anchorage, Alaska, August 2014 . Regional Scientific Meetings are also held in the IEA regions during three-year periods between WCEs. The IEA is in official relations with the World Health Organization (WHO) and is run by a council including executive and regional councilors for its 7 regions in addition to the ex-officio members.
  • 884
  • 25 Oct 2022
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