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Topic Review
Isocitrate Dehydrogenase Mutations in Glioma
Mutations in isocitrate dehydrogenase (IDH) are commonly observed in lower-grade glioma and secondary glioblastomas. IDH mutants confer a neomorphic enzyme activity that converts α-ketoglutarate to an oncometabolite D-2-hydroxyglutarate, which impacts cellular epigenetics and metabolism. IDH mutation establishes distinctive patterns in metabolism, cancer biology, and the therapeutic sensitivity of glioma. Thus, a deeper understanding of the roles of IDH mutations is of great value to improve the therapeutic efficacy of glioma and other malignancies that share similar genetic characteristics.
  • 514
  • 25 Jun 2021
Topic Review
Medical Uses of N-Acetylcysteine
N-acetylcysteine (NAC), a plant antioxidant naturally found in onion, is a precursor to glutathione. It has been used as a drug since the 1960s and is listed on the World Health Organization (WHO) Model List of Essential Medicines as an antidote in poisonings. There are numerous other uses or proposed uses in medicine that are still in preclinical and clinical investigations. NAC is also used in food supplements and cosmetics. Despite its abundant use, there are projections that the NAC global market will grow in the next five years; therefore, the purpose of this work is to provide a balanced view of further uses of NAC as a dietary supplement. Although NAC is considered a safe substance, the results among clinical trials are sometimes controversial or incomplete, like for many other antioxidants. More clinical trials are underway that will improve our understanding of NAC applicability.
  • 513
  • 16 Aug 2021
Topic Review Peer Reviewed
Kidney Issues Associated with COVID-19 Disease
Infection with SARS-CoV-2 and the resulting COVID-19 can cause both lung and kidney damage. SARS-CoV-2 can directly infect renal cells expressing ACE2 receptors, resulting in kidney damage, and acute kidney injury (AKI) has been reported in COVID-19 hospitalized patients. The pathophysiology of COVID-19-associated AKI is multifactorial. Local and systemic inflammation, immune system dysregulation, blood coagulation disorders, and activation of the renin-angiotensin-aldosterone system (RAAS) are factors that contribute to the development of AKI in COVID 19 disease. COVID-19 patients with kidney involvement have a poor prognosis, and patients with chronic kidney disease (CKD) infected with SARS-CoV-2 have an increased mortality risk. CKD patients with COVID-19 may develop end-stage renal disease (ESRD) requiring dialysis. In particular, patients infected with SARS-CoV-2 and requiring dialysis, as well as patients who have undergone kidney transplantation, have an increased risk of mortality and require special consideration. Nephrologists and infectious disease specialists face several clinical dilemmas in the prophylaxis and treatment of CKD patients with COVID-19. This entry presents recent data showing the effects of COVID-19 on the kidneys and CKD patients and the challenges in the management of CKD patients with COVID-19, and discusses treatment strategies for these patients.
  • 515
  • 05 Sep 2023
Topic Review
Supportive Psychotherapy
Supportive psychotherapy is a psychotherapeutic approach that integrates various therapeutic schools such as psychodynamic and cognitive-behavioral, as well as interpersonal conceptual models and techniques. The aim of supportive psychotherapy is to reduce or to relieve the intensity of manifested or presenting symptoms, distress or disability. It also reduces the extent of behavioral disruptions caused by the patient's psychic conflicts or disturbances. Unlike in psychoanalysis, in which the analyst works to maintain a neutral demeanor as a "blank canvas" for transference, in supportive therapy the therapist engages in a fully emotional, encouraging, and supportive relationship with the patient as a method of furthering healthy defense mechanisms, especially in the context of interpersonal relationships. Supportive psychotherapy can be used as treatment for a variety of physical, mental, and emotional ailments, and consists of a variety of strategies and techniques in which therapists or other licensed professionals can treat their patients. The objective of the therapist is to reinforce the patient's healthy and adaptive patterns of thought behaviors in order to reduce the intrapsychic conflicts that produce symptoms of mental disorders.
  • 512
  • 09 Nov 2022
Topic Review
Liposomal Cytarabine
Cancer is the second leading cause of death worldwide. The main modality to fight against cancer is surgery, radiotherapy, and chemotherapy, and more recently targeted therapy, gene therapy and immunotherapy, which play important roles in treating cancer patients. In the last decades, chemotherapy has been well developed. Nonetheless, administration of the drug is not always successful, as limited drug dosage can reach the tumor cells.. In this context, the possibility to use an encapsulated anti-cancer drug may potentially solve the problem. Liposomal cytarabine is a formulation with pronounced effectiveness in lymphomatous meningitis and reduced cardiotoxicity if compared to liposomal anthracyclines. Thus, the future liposomal cytarabine use could be extended to other diseases given its reduction in cytotoxic side effects compared to the free formulation. 
  • 505
  • 22 Jul 2021
Topic Review
Diabetic Patients
Roughly 3% of patients worldwide with a new diagnosis of type 2 diabetes mellitus (T2DM) already have an overt nephropathy at diagnosis and about 20–30% of the remaining ones develop a complication of this kind later in life. The early identification of kidney disease in diabetic patients is important as it slows its progression, which is important not only because this reduces the need for renal replacement therapy, but also because it decreases the high rate of mortality and morbidity associated with a reduction in kidney function. 
  • 503
  • 16 Jun 2021
Topic Review
Pathogenesis, Diagnostics, and Therapeutics for Human Monkeypox Disease
The monkeypox disease is a zoonotic-infectious disease that transmits between animals and humans. It is caused by a double-stranded DNA virus belonging to the Orthopoxvirus genus that is closely related to the variola virus –the causative agent of smallpox.
  • 500
  • 25 Dec 2022
Topic Review
Bone Health in Patients with Dyslipidemias
Despite the high heterogeneity and the variable quality of evidence, dyslipidemia, mainly high TC and LDL-C and, to a lesser extent, TG concentrations, seems to be associated with low bone mass and increased fracture risk. This detrimental effect may be mediated directly through the increased oxidative stress and systemic inflammation that dyslipidemia is associated with, leading to increased osteoclastic activity and reduced bone formation, or through the atherosclerotic process, which affects bone’s vascularization. Other mechanisms, such as low estrogen, vitamin D and K status, and increased concentrations of PTH, homocysteine, and lipid oxidation products, may also contribute to this interplay. Regarding the effect of lipid-lowering therapy on bone metabolism, statins may slightly increase BMD, with a tendency to reduce fracture risk as shown in case-control and cohort studies, although available RCTs have not shown any effect of statins on fracture risk. This is also the case for omega-3 FA, whereas inconsistent or insufficient evidence exists for other commonly used lipid-lowering medications, such as ezetimibe, fibrates, and niacin. There is an exigent need for prospective, well-designed studies in males and females to elaborate on the putative association between lipids and bone strength.
  • 501
  • 14 Feb 2022
Topic Review
Bowel Ultrasound
Inflammatory bowel diseases (IBD) are chronic, progressive, and disabling conditions, characterized by a relapsing and remitting behavior and long-term complications (i.e., colo-rectal cancer and demolitive surgery). Dedicated physicians are becoming confident with the ”treat-to-target” strategy in the management of IBD, aiming to prevent end-organ dysfunction. For years, symptom control has been the primary therapeutic goal of IBD patients.
  • 500
  • 13 Jul 2021
Topic Review
Dyslipidemia
Dyslipidemia is a significant threat to public health worldwide and the identification of its pathogenic mechanisms, as well as novel lipid-lowering agents, are warranted. Magnesium (Mg) is a key element to human health and its deficiency has been linked to the development of lipid abnormalities and related disorders, such as the metabolic syndrome, type 2 diabetes mellitus, or cardiovascular disease.
  • 500
  • 07 May 2021
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