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Topic Review
Metformin’s Effects
Today the area of application of metformin is expanding, the recent important change is a removal of a number of restrictions on its use in patients with heart failure, acute coronary syndrome and chronic kidney disease.
  • 712
  • 22 Apr 2022
Topic Review
RORA Elevation
Round Oak Rag Apple Elevation (born 1965, often abbreviated RORA Elevation), was one of the most influential artificial insemination Holstein/Friesian bulls of the last century. Elevation was named bull of the century by the Holstein International Association in 1999. Elevation was sired by Tidy Burke Elevation, a highly inbred bull from the Burke bloodline. His dam, Round Oak Ivanhoe Eve, was sired by the famous 1950's bull Osborndale Ivanhoe. Elevation was born in Virginia, bred by Ronald Hope, and was later owned by the artificial insemination company Select Sires. Elevation had many famous sons, including Sweet-Haven Tradition, Rockalli Son of Bova, Marshfield Elevation Tony and Straight-Pine Elevation Pete. In Canada, he had Hanoverhill Starbuck, an influential sire of sons worldwide. As of April 2009, Elevation is considered to be the bull with most actual descendents in the United States, by the Sire Summaries April 2009, of the Holstein Association.
  • 702
  • 09 Oct 2022
Topic Review
Route of Administration in the Musculoskeletal System
The musculoskeletal system (MSKS) is composed of specialized connective tissues including bone, muscle, cartilage, tendon, ligament, and their subtypes. The primary function of the MSKS is to provide protection, structure, mobility, and mechanical properties to the body. In the process of fulfilling these functions, the MSKS is subject to wear and tear during aging and after injury and requires subsequent repair. MSKS diseases are a growing burden due to the increasing population age. 
  • 701
  • 19 Jul 2023
Topic Review
Infections&Immunotherapy in Lung Cancer
Infectious diseases represent a relevant issue in lung cancer patients. Bacterial and viral infections might influence the patients’ prognosis, both directly affecting the immune system and indirectly impairing the outcome of anticancer treatments, mainly immunotherapy. In this analysis, we aimed to review the current evidence in order to clarify the complex correlation between infections and lung cancer. In detail, we mainly explored the potential impact on immunotherapy outcome/safety of (1) bacterial infections, with a detailed focus on antibiotics; and (2) viral infections, discriminating among (a) human immune-deficiency virus (HIV), (b) hepatitis B/C virus (HBV-HCV), and (c) Sars-Cov-2. A series of studies suggested the prognostic impact of antibiotic therapy administration, timing, and exposure ratio in patients treated with immune checkpoint inhibitors, probably through an antibiotic-related microbiota dysbiosis. Although cancer patients with HIV, HBV, and HCV were usually excluded from clinical trials evaluating immunotherapy, some retrospective and prospective trials performed in these patient subgroups reported similar results compared to those described in not-infected patients, with a favorable safety profile. Moreover, patients with thoracic cancers are particularly at risk of COVID-19 severe outcomes and mortality. Few reports speculated about the prognostic implications of anticancer therapy, including immunotherapy, in lung cancer patients with concomitant Sars-Cov-2 infection, showing, to date, inconsistent results. The correlation between infectious diseases and immunotherapy remains to be further explored and clarified in the context of dedicated trials. In clinical practice, the accurate and prompt multidisciplinary management of lung cancer patients with infections should be encouraged in order to select the best treatment options for these patients, avoiding unexpected toxicities, while maintaining the anticancer effect.
  • 697
  • 13 Jan 2021
Topic Review
Prehabilitation
Pelvic organ prolapse and urinary incontinence affect approximately 6–11% and 6–40% of women, respectively. These pathologies could result from a weakness of pelvic floor muscles (PFM) caused by previous deliveries, ageing or surgery. It seems reasonable that improving PFM efficacy should positively impact both pelvic floor therapy and surgical outcomes. Nonetheless, the existing data are inconclusive and do not clearly support the positive impact of preoperative pelvic floor muscle training on the improvement of surgical results. The restoration of deteriorated PFM function still constitutes a challenge. Thus, further well-designed prospective studies are warranted to answer the question of whether preoperative PFM training could optimize surgical outcomes and if therapeutic actions should focus on building muscle strength or rather on enhancing muscle performance.
  • 695
  • 26 Nov 2020
Topic Review
Brain Connectivity in Migraine
A neuronal dysfunction based on the imbalance between excitatory and inhibitory cortical-subcortical neurotransmission seems at the basis of migraine. Intercritical neuronal abnormal excitability can culminate in the bioelectrical phenomenon of Cortical Spreading Depression (CSD) with secondary involvement of the vascular system and release of inflammatory mediators, modulating in turn neuronal activity. Neuronal dysfunction encompasses the altered connectivity between the brain areas implicated in the genesis, maintenance and chronic evolution of migraine. Advanced neuroimaging techniques allow to identify changes in functional connectivity (FC) between brain areas involved in pain processes. Through a narrative review, we re-searched case-control studies on FC in migraine, between 2015 and 2020, by inserting the words migraine, fMRI, EEG, MEG, connectivity, pain in Pubmed. Studies on FC have shown that cortical processes, in the neurolimbic pain network, are likely to be prevalent for triggering attacks, in response to predisposing factors, and that these lead to a demodulation of the subcortical areas, at the basis of migraine maintenance. The link between brain dysfunction and peripheral interactions through the inhibition of CGRP, the main mediator of sterile migraine inflammation needs to be further investigated. Preliminary evidence could suggest that peripheral nerves inference at somatic and trigeminal levels, appears to change brain FC.
  • 693
  • 05 Mar 2021
Topic Review
Microfluidics in Drug Development from Traditional Medicine
Microfluidic chip technology has spread throughout every step of the drug development process and plays an integral role, but classical drug development strategies are inadequate. Although numerous drugs have been produced for epidemic diseases, the mortality rate is still high globally. Over time, traditional medicine has been a powerful therapy for many illnesses. Therefore, the development of new drugs from traditional medicine is a promising strategy. New drug development from traditional medicine, either by obtaining the active ingredient directly from existing natural drugs or through direct modification of a traditional drug formulation, has received increasing attention as a powerful way to address this problem. However, there are quite a few hurdles to overcome when trying to develop new drugs from traditional medicine. Fortunately, microfluidic chip technology also plays an irreplaceable role in the strategy of new drug development from traditional medicine and can be applied to all aspects of the drug development process. However, there are currently insufficient reviews on the role of microfluidic chip technology in the development of new drugs from conventional medicine. Herein, the application of microfluidics in two major steps of drug development from traditional medicine has been described: the separation and purification of target components from complex samples and the screening of active components.
  • 691
  • 27 Oct 2022
Topic Review
Intraarticular Injections of MSC in Knee Osteoarthritis
More than 10% of the world’s population suffers from osteoarthritis (OA) of the knee, with a lifetime risk of 45%. Treatments for knee OA pain are as follows: weight control; oral pharmacological treatment (non-steroidal anti-inflammatory drugs, paracetamol, opioids); mechanical aids (crutches, walkers, braces, orthotics); therapeutic physical exercise; and intraarticular injections of corticosteroids, hyaluronic acid, and platelet-rich plasma (PRP). The problem is that such treatments usually relieve joint pain for only a short period of time. With respect to intraarticular injections, corticosteroids relieve pain for several weeks, while hyaluronic acid and PRP relieve pain for several months. When the above treatments fail to control knee pain, total knee arthroplasty (TKA) is usually indicated; however, although a very effective surgical technique, it can be associated with medical and postoperative (surgery-related) complications. Therefore, it seems essential to look for safe and effective alternative treatments to TKA. There has been much research on intraarticular injections of mesenchymal stem cells (MSCs) for the management of OA of the knee joint.
  • 688
  • 12 Dec 2022
Topic Review
Application of Mass Spectrometry Imaging in Personalized Medicine
Novel profiling methodologies are redefining the diagnostic capabilities and therapeutic approaches towards more precise and personalized healthcare. Complementary information can be obtained from different omic approaches in combination with the traditional macro- and microscopic analysis of the tissue, providing a more complete assessment of the disease. Mass spectrometry imaging, as a tissue typing approach, provides information on the molecular level directly measured from the tissue.
  • 685
  • 25 Jul 2022
Topic Review
Sarcopenia in Chronic Liver Disease
Sarcopenia is prevalent in patients with chronic liver disease, and affected patients tend to have worse clinical outcomes and higher mortality. However, relevant analyses are limited by heterogeneity in the definition of sarcopenia and in the methodological approaches in assessing it.
  • 684
  • 23 Feb 2021
Topic Review
Pitfalls Caveats in Chromogenic Immunostaining
In daily diagnostic pathology services, chromogenic immunostaining using formalin-fixed, paraffin-embedded (FFPE) sections is indispensable to help in the histopathological diagnosis fundamentally based on hematoxylin and eosin (H&E) staining. Differential diagnoses are determined first, and appropriate immunohistochemical markers for the diagnoses are then selected. The expression of lymphocyte surface markers, hormones and tumor markers contributes to the functional classification of tumors. The degree of malignancy can be analyzed by immunostaining for p53 and Ki-67 (MIB-1), a cell proliferation marker, in a variety of malignancies including carcinomas of the oral cavity, colon, and breast.
  • 684
  • 07 Jul 2021
Topic Review
Practice Recommendations of Patient-Centered Tele-Palliative Care
Cancer patients receiving palliative care may face significant challenges in attending outpatient appointments. Patients on controlled substances such as opioids require frequent visits and often rely on assistive devices and/or a caregiver to accompany them to these visits. In addition, pain, fatigue, and shortness of breath may magnify the challenges associated with in-person visits. The rapid adoption of telemedicine in response to the COVID-19 pandemic has proven to be highly beneficial for advanced cancer patients and caregivers. The hurried COVID-19-related implementation of telemedicine is now evolving into a permanent platform for providing palliative care.
  • 680
  • 14 Apr 2023
Topic Review
Neurooncology
Neuro-oncology is the study of brain and spinal cord neoplasms, many of which are (at least eventually) very dangerous and life-threatening (astrocytoma, glioma, glioblastoma multiforme, ependymoma, pontine glioma, and brain stem tumors are among the many examples of these). Among the malignant brain cancers, gliomas of the brainstem and pons, glioblastoma multiforme, and high-grade (highly anaplastic) astrocytoma are among the worst. In these cases, untreated survival usually amounts to only a few months, and survival with current radiation and chemotherapy treatments may extend that time from around a year to a year and a half, possibly two or more, depending on the patient's condition, immune function, treatments used, and the specific type of malignant brain neoplasm. Surgery may in some cases be curative, but, as a general rule, malignant brain cancers tend to regenerate and emerge from remission easily, especially highly malignant cases. In such cases, the goal is to excise as much of the mass (tumor cells) and as much of the tumor margin as possible without endangering vital functions or other important cognitive abilities.
  • 678
  • 28 Oct 2022
Topic Review
Sorafenib-Based Nanomedicine
Sorafenib (SF) is a US Food and Drug Administration (FDA)-approved molecular-targeted chemotherapeutic agent, which is used as a clinic standard drug for hepatocellular carcinoma (HCC). The overall patient survival is increased by delaying the pathologic progression. SF is also an oral multikinase inhibitor by inhibiting the proliferation of tumor cells, neoplastic angiopoiesis, angiogenesis and invasion of cancer cells. So, SF is regarded as an effective chemotherapeutic agent against various types of tumors
  • 677
  • 07 Jul 2023
Topic Review
Replicative Cycle of HHV8
Around 12% of all cancers worldwide are caused by oncogenic viruses. Among these, only Kaposi’s sarcoma-associated herpesvirus (KSHV) and the human papillomavirus are an absolute requirement of oncogenesis for both their respectively determined cancers, and both are direct carcinogens. KSHV, also known as the Human gammaherpesvirus 8 (HHV8), is a double-stranded DNA and a Rhadinovirus, the only one of the genus with human tropism. HHV8 is found in all types of Kaposi’s sarcoma, and is needed for Kaposi’s sarcoma to appear, although the infection by itself is not enough. 
  • 677
  • 30 May 2022
Topic Review
Patient Navigators
Patient navigators educate and assist United States citizens in enrolling into health benefit plans stipulated in the Patient Protection and Affordable Care Act (ACA). Patient navigators are also called "insurance navigators" or "in-person assisters" who have defined roles under the ACA. Although their roles might overlap, patient navigators are not community health workers or health advocates. "Navigators" work in states with Federally-Facilitated Exchanges (FFEs) or State Partnership Exchanges. Under the ACA, a health insurance marketplace, or exchange, is required to develop and fund a patient navigator program. The patient navigator's primary role, as defined in section 1311, is to educate the public on information about health care plans, to facilitate enrollment into health plans, and provide information for tax credits and cost-sharing reductions. The education and information provided by patient navigators must be culturally and linguistically appropriate and provided in a fair and impartial manner. Patient navigators are required to meet standards and core proficiencies established by the Secretary of Health and Human Services.
  • 676
  • 19 Oct 2022
Topic Review
Mental Health Awareness Month
Mental Health Awareness Month (also referred to as "Mental Health Month") has been observed in May in the United States since 1949, reaching millions of people in the United States through the media, local events, and screenings. Mental Health Awareness Month was started in the United States in 1949 by the Mental Health America organization (then known as the National Association for Mental Health). Each year in mid-March Mental Health America releases a toolkit of materials to guide preparation for outreach activities during Mental Health Awareness Month. During the month of May, Mental Health America, its affiliates, and other organizations interested in mental health conduct a number of activities which are based on a different theme each year. 
  • 675
  • 25 Oct 2022
Topic Review
QbD for Industrial Pharmacy in Costa Rican Academy
The Quality by Design (QbD) model stands out as a great methodology for carrying out research projects regarding Pharmaceutical Sciences, but especially for Industrial Pharmacy, where it has contributed in terms of formulation development, manufacturing, and quality control. Academic research based on this model enables the training and development of practical, scientific, and leadership skills in Industrial Pharmacy students. The generated knowledge can be shared in classrooms, which represents an ideal environment to communicate research results and to foster collaborative work between researchers, professors, and students. Moreover, research performed through a QbD approach increases the confidence shown by the industrial sector and health regulatory authorities in the quality of the research, products, and knowledge that are developed and created in an Academy. As a result, the implementation of the model has allowed the creation, transfer, and materialization of knowledge from the Costa Rican Academy to different local pharmaceutical industries. 
  • 674
  • 10 Jun 2022
Topic Review
Biomarker
In medicine, a biomarker is a measurable indicator of the severity or presence of some disease state. More generally a biomarker is anything that can be used as an indicator of a particular disease state or some other physiological state of an organism. According to the WHO, the indicator may be chemical, physical, or biological in nature - and the measurement may be functional, physiological, biochemical, cellular, or molecular. A biomarker can be a substance that is introduced into an organism as a means to examine organ function or other aspects of health. For example, rubidium chloride is used in isotopic labeling to evaluate perfusion of heart muscle. It can also be a substance whose detection indicates a particular disease state, for example, the presence of an antibody may indicate an infection. More specifically, a biomarker indicates a change in expression or state of a protein that correlates with the risk or progression of a disease, or with the susceptibility of the disease to a given treatment. Biomarkers can be characteristic biological properties or molecules that can be detected and measured in parts of the body like the blood or tissue. They may indicate either normal or diseased processes in the body. Biomarkers can be specific cells, molecules, or genes, gene products, enzymes, or hormones. Complex organ functions or general characteristic changes in biological structures can also serve as biomarkers. Although the term biomarker is relatively new, biomarkers have been used in pre-clinical research and clinical diagnosis for a considerable time. For example, body temperature is a well-known biomarker for fever. Blood pressure is used to determine the risk of stroke. It is also widely known that cholesterol values are a biomarker and risk indicator for coronary and vascular disease, and that C-reactive protein (CRP) is a marker for inflammation. Biomarkers are useful in a number of ways, including measuring the progress of disease, evaluating the most effective therapeutic regimes for a particular cancer type, and establishing long-term susceptibility to cancer or its recurrence. The parameter can be chemical, physical or biological. In molecular terms biomarker is "the subset of markers that might be discovered using genomics, proteomics technologies or imaging technologies. Biomarkers play major roles in medicinal biology. Biomarkers help in early diagnosis, disease prevention, drug target identification, drug response etc. Several biomarkers have been identified for many diseases such as serum LDL for cholesterol, blood pressure, and P53 gene and MMPs as tumor markers for cancer.
  • 673
  • 22 Nov 2022
Topic Review
AAA 400 Drive for Autism
The AAA 400 Drive for Autism is a 400-mile (640 km) Monster Energy NASCAR Cup Series stock car race held annually at Dover International Speedway in Dover, Delaware, the other one being the Dover 400, the fall race at Dover, for the NASCAR Chase for the Championship, it is the first of two Monster Energy NASCAR Cup Series races at Dover. The 2007 Autism Speaks 400 presented by Visa marked the first time that a NASCAR Cup race entitlement was dedicated to a non-profit organization, by the race's title sponsor, Visa Inc. Starting in 2007 through 2017, Dover International Speedway announced that the 2007 race would be named the “Autism Speaks 400 presented by Visa" , dedicating to increasing understanding and knowledge of autism spectrum disorders; to funding dedicated to eugenics; and to advocating for the needs of affected families. Between 2001 and 2006, the race was broadcast in the United States on FX. Television coverage of the race moved to the Fox network beginning in 2007, but after eight years, the race returned to cable television with Fox Sports 1.
  • 672
  • 08 Nov 2022
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