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Topic Review
Managing Colorectal Cancer from Ethology to Interdisciplinary Treatment
Colorectal cancer (CRC) is a common malignant tumor of the gastrointestinal tract, which has become a serious threat to human health worldwide. CRC is a complex disease due to its extensive heterogeneity; thus, effective treatment could be enhanced by the implementation of a personalized medicine approach. Despite constantly improved diagnostic and individualized therapeutic methods, CRC remains one of the biggest problems of contemporary medicine. Knowledge of the basic risk factors, early clinical symptoms, and available screening tests, as well as the preservation of oncological alert, allow the proper targeting of the diagnostic process and, consequently, the earlier diagnosis of the disease. Undoubtedly, new research at the molecular and genetic level allows us to precisely understand the process of initiation and progression of cancerous diseases and, consequently, precise, personalized prevention and treatment.
  • 96
  • 23 Feb 2024
Topic Review
Maternal Selenium and Developmental Programming
Selenium (Se) is an essential trace element of fundamental importance to health due to its antioxidant, anti-inflammatory, and chemopreventive properties, attributed to its presence within at least 25 selenoproteins (Sel).
  • 517
  • 11 Aug 2021
Topic Review
Mechanical Heart Valve Patients with Intracranial Hemorrhage
The management of an intracranial hemorrhage in patients receiving anticoagulant therapy presents a significant challenge for medical professionals. Anticoagulant treatment is intended to prevent blood clotting, but it can worsen active brain bleeds. Despite this risk, avoiding the prothrombotic state caused by mechanical heart valves remains crucial. 
  • 306
  • 17 May 2023
Topic Review
Mechanisms of Kidney Damage in Acute Hepatic Porphyrias
Porphyrias are a group of rare disorders originating from an enzyme dysfunction in the pathway of heme biosynthesis. Depending on the specific enzyme involved, porphyrias manifest under drastically different clinical pictures. The most dramatic presentation of the four congenital acute hepatic porphyrias (AHPs: acute intermittent porphyria—AIP, ALAD deficiency, hereditary coproporphyria—HCP, and porphyria variegata—VP) consists of potentially life-threatening neurovisceral attacks, for which givosiran, a novel and effective siRNA-based therapeutic, has recently been licensed. Nonetheless, the clinical manifestations of acute porphyrias are multifaceted and do not limit themselves to acute attacks. In particular, porphyria-associated kidney disease (PAKD) is a distinct, long-term degenerating condition with specific pathological and clinical features, for which a satisfactory treatment is not available yet. In PAKD, chronic tubule-interstitial damage has been most commonly reported, though other pathologic features (e.g., chronic fibrous intimal hyperplasia) are consistent findings. Given the relevant role of the kidney in porphyrin metabolism, the mechanisms possibly intervening in causing renal damage in AHPs are different: among others, δ-aminolevulinic acid (ALA)-induced oxidative damage on mitochondria, intracellular toxic aggregation of porphyrins in proximal tubular cells, and derangements in the delicate microcirculatory balances of the kidney might be implicated. The presence of a variant of the human peptide transporter 2 (PEPT2), with a greater affinity to its substrates (including ALA), might confer a greater susceptibility to kidney damage in patients with AHPs. Furthermore, a possible effect of givosiran in worsening kidney function has been observed. In sum, the diagnostic workup of AHPs should always include a baseline evaluation of renal function, and periodic monitoring of the progression of kidney disease in patients with AHPs is strongly recommended.
  • 576
  • 07 Feb 2022
Topic Review
Mechanistic Basis for Autophagy in Diabetic Kidney Disease
Diabetic kidney disease (DKD), or diabetic nephropathy (DN), is a common but severe complication in diabetic patients. The disorder mainly consists of persistent proteinuria with progressive worsening of renal function, and can ultimately cause irreversible kidney damage. Studies have provided new insights into the connection between autophagy, a physiological metabolic process known to maintain cellular homeostasis, and the pathophysiological pathways of DKD. Typically, autophagic activity plays a role in DKD progression mainly by promoting an inflammatory response to tissue damage, while both overactivated and downregulated autophagy worsen disease outcomes in different stages of DKD. 
  • 170
  • 13 Dec 2023
Topic Review
Medical Insights of Hemodiafiltration
Hemodiafiltration, a dialysis method that was implemented in clinics many years ago and that combines the two main principles of hemodialysis and hemofiltration—diffusion and convection—has had a positive impact on mortality rates, especially when delivered in a high-volume mode as a surrogate for a high convective dose. The achievement of high substitution volumes during dialysis treatments does not only depend on patient characteristics but also on the dialyzer (membrane) and the adequately equipped hemodiafiltration machine. 
  • 314
  • 07 Feb 2023
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.
  • 510
  • 16 Aug 2021
Topic Review
Medicinal Plants of the Himalayas
WHO recommends cancer is the leading cause of death worldwide, with nearly 10 million deaths predicted in 2020(1). The bioactivities of phytocompounds for various health benefits have been studied for decades. Synthetic drugs are being replaced by phytocompounds which have great advantages due to their effects on a wide range of target cells with lower cell cytotoxicity effects or side effects compared to synthetic anticancer compounds, which are a single-target effect for prevention and treatment of carcinoma. Various medicinal plants and their nanoparticles have anticancer activity, namely Murraya koenigii leaf extract ZnO nanoparticlets. Most modern drugs used to treat cancer originate from various medicinal plants; 50% of the anticancer drugs originate from medicinal plants. In developing countries, more than 80% of people use medicinal plants as traditional medicinal therapy and 60% of cancer patients use herbal treatment as an option to cure cancer. Currently, for high-risk breast cancer patients, tamoxifen and related compounds such as raloxifene are prescribed. The phytocompounds most studied in different research papers for the treatment of cancer (anti-proliferative activity) are curcumin, polyphenols, Withaferin A (WFA), a triterpenoid, celastrol, and berry bioactives. Vinca alkaloids, podophyllotoxin, taxanes, campothecin, homoharringtonine, saponin, isoquinoline, shatavarine IV, stigamsterola, calotropin, and shikonin phytocompounds are discussed as follows. Cancer as well as boosting the immune system.
  • 417
  • 22 Aug 2022
Topic Review
Melatonin in Cancer Treatment
Melatonin is a pleotropic molecule with numerous biological activities. Epidemiological and experimental studies have documented that melatonin could inhibit different types of cancer in vitro and in vivo.
  • 695
  • 02 Jul 2021
Topic Review
Metabolic Obesity in People with Normal Body Weight
The term Metabolic Obesity in People with Normal Body Weight (MONW) is used to describe people who, despite having a healthy body weight - usually defined by the body index (BMI), and more and more often also the percentage of adipose tissue - show metabolic disorders characteristic of obese people. 
  • 477
  • 29 Mar 2022
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