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Topic Review
Altered Pathways in Fabry Disease
Fabry disease is a rare X-linked disease characterized by deficient expression and activity of alpha-galactosidase A (α-GalA) with consequent lysosomal accumulation of glycosphingolipid in various organs. Enzyme replacement therapy is the cornerstone of the treatment of all Fabry patients, although in the long-term it fails to completely halt the disease’s progression. This suggests on one hand that the adverse outcomes cannot be justified only by the lysosomal accumulation of glycosphingolipids and on the other that additional therapies targeted at specific secondary mechanisms might contribute to halt the progression of cardiac, cerebrovascular, and renal disease that occur in Fabry patients. 
  • 275
  • 15 Mar 2023
Topic Review
Oxidative Stress in Type 2 Diabetes
Oxidative stress is a critical factor in the pathogenesis and progression of diabetes and its associated complications. The imbalance between reactive oxygen species (ROS) production and the body’s antioxidant defence mechanisms leads to cellular damage and dysfunction. In diabetes, chronic hyperglycaemia and mitochondrial dysfunction contribute to increased ROS production, further exacerbating oxidative stress. This oxidative burden adversely affects various aspects of diabetes, including impaired beta-cell function and insulin resistance, leading to disrupted glucose regulation. Additionally, oxidative stress-induced damage to blood vessels and impaired endothelial function contribute to the development of diabetic vascular complications such as retinopathy, nephropathy, and cardiovascular diseases. Moreover, organs and tissues throughout the body, including the kidneys, nerves, and eyes, are vulnerable to oxidative stress, resulting in diabetic nephropathy, neuropathy, and retinopathy. Strategies to mitigate oxidative stress in diabetes include antioxidant therapy, lifestyle modifications, and effective management of hyperglycaemia
  • 273
  • 18 Aug 2023
Topic Review
Dyadic Developmental Psychotherapy
Dyadic developmental psychotherapy is a psychotherapeutic treatment method for families that have children with symptoms of emotional disorders, including complex trauma and disorders of attachment. It was originally developed by Daniel Hughes as an intervention for children whose emotional distress resulted from earlier separation from familiar caregivers. Hughes cites attachment theory and particularly the work of John Bowlby as theoretical motivations for dyadic developmental psychotherapy. Dyadic developmental therapy principally involves creating a "playful, accepting, curious, and empathic" environment in which the therapist attunes to the child's "subjective experiences" and reflects this back to the child by means of eye contact, facial expressions, gestures and movements, voice tone, timing and touch, "co-regulates" emotional affect and "co-constructs" an alternative autobiographical narrative with the child. Dyadic developmental psychotherapy also makes use of cognitive-behavioral strategies. The "dyad" referred to must eventually be the parent-child dyad. The active presence of the primary caregiver is preferred but not required. A study by Arthur Becker-Weidman in 2006, which suggested that dyadic developmental therapy is more effective than the "usual treatment methods" for reactive attachment disorder and complex trauma, has been criticised by the American Professional Society on the Abuse of Children (APSAC). According to the APSAC Taskforce Report and Reply, dyadic developmental psychotherapy does not meet the criteria for designation as "evidence based" nor provide a basis for conclusions about "usual treatment methods". A 2006 research synthesis described the approach as a "supported and acceptable" treatment, but this conclusion has also proved controversial. A 2013 review of research recommended caution about this method of therapy, arguing that it has "no support for claims of effectiveness at any level of evidence" and a questionable theoretical basis.
  • 269
  • 17 Nov 2022
Topic Review
Dopamine in Glucose Homeostasis and Type 2 Diabetes
Dopamine regulates several functions, such as voluntary movements, spatial memory, motivation, sleep, arousal, feeding, immune function, maternal behaviors, and lactation. Less clear is the role of dopamine in the pathophysiology of type 2 diabetes mellitus (T2D) and chronic complications and conditions frequently associated with it.
  • 267
  • 27 Nov 2023
Topic Review
Biological Links between Aging and Frailty
The life expectancy of the global population has increased. Aging is a natural physiological process that poses major challenges in an increasingly long-lived and frail population. Several molecular mechanisms are involved in aging.
  • 267
  • 15 Mar 2023
Topic Review
Role of Sodium-Glucose Co-Transporter 2 Inhibitors
Diabetic kidney disease (DKD) causes a progressive decline in renal function, leading to end-stage kidney disease (ESKD), and increases the likelihood of cardiovascular events and mortality. The introduction of the sodium-glucose co-transporter 2 (SGLT-2) inhibitor has been a game changer in managing chronic kidney disease (CKD) and congestive heart failure (CHF). These agents not only slow down the progression of kidney disease but also have cardioprotective benefits, including for patients with congestive heart failure and atherosclerotic cardiovascular disease. Some evidence suggests that they can decrease the risk of stroke as well.
  • 265
  • 20 Oct 2023
Topic Review
Insulin and Transcriptional Regulation of Lipid Metabolism
There is a wide variety of kinds of lipids, and complex structures which determine the diversity and complexity of their functions. With the basic characteristic of water insolubility, lipid molecules are independent of the genetic information composed by genes to proteins, which determine the particularity of lipids in the human body, with water as the basic environment and genes to proteins as the genetic system. After the well-studied PI3K-AKT pathway, insulin affects fat synthesis by controlling the activity and production of various transcription factors.
  • 263
  • 31 Oct 2022
Topic Review
Developmental Needs Meeting Strategy
The Developmental Needs Meeting Strategy (DNMS) is a psychotherapy approach developed by Shirley Jean Schmidt, MA, LPC. It is designed to treat adults with psychological trauma wounds (such as those inflicted by verbal, physical, and sexual abuse) and with attachment wounds (such as those inflicted by parental rejection, neglect, and enmeshment). The DNMS is an ego state therapy based on the assumption that the degree to which developmental needs were not adequately met is the degree to which a client may be stuck in childhood. This model aims to identify ego states that are stuck in the past and help them get unstuck by remediating those unmet developmental needs. The processing starts with the DNMS therapist guiding a patient to mobilize three internal Resource ego states: a Nurturing Adult Self, a Protective Adult Self, and a Spiritual Core Self. The therapist then guides these three Resources to gently help wounded child ego states get unstuck from the past by meeting their unmet developmental needs, helping them process through painful emotions, and by establishing an emotional bond. The relationship wounded child parts have with these Resources is considered the primary agent for change. Alternating bilateral stimulation (made popular by EMDR therapy) is applied at key points in the protocol to enhance the process. The DNMS focuses special attention on healing maladaptive introjects (wounded ego states that mimic abusive, neglectful, or dysfunctional caregivers. The model assumes that these ego states cause the most trouble for clients, so helping them heal may result in a significant benefit – leading to a decrease in unwanted behaviors, beliefs, and emotions.
  • 262
  • 01 Nov 2022
Topic Review
High-Risk Pregnancy
A high-risk pregnancy is one where the mother or the fetus has an increased risk of adverse outcomes compared to uncomplicated pregnancies. No concrete guidelines currently exist for distinguishing “high-risk” pregnancies from “low-risk” pregnancies, however there are certain studied conditions that have been shown to put the mother or fetus at a higher risk of poor outcomes. These conditions can be classified into three main categories: health problems in the mother that occur before she becomes pregnant, health problems in the mother that occur during pregnancy, and certain health conditions with the fetus. In 2012, the CDC estimated that there were approximately 65,000 pregnancies deemed "high-risk" in the United States.
  • 261
  • 14 Nov 2022
Topic Review
The Ca2+ Sensor STIM in Human Diseases
The STIM family of proteins plays a crucial role in a plethora of cellular functions through the regulation of store-operated Ca2+ entry (SOCE) and, thus, intracellular calcium homeostasis. The two members of the mammalian STIM family, STIM1 and STIM2, are transmembrane proteins that act as Ca2+ sensors in the endoplasmic reticulum (ER) and, upon Ca2+ store discharge, interact with and activate the Orai/CRACs in the plasma membrane. Dysregulation of Ca2+ signaling leads to the pathogenesis of a variety of human diseases, including neurodegenerative disorders, cardiovascular diseases, cancer, and immune disorders. 
  • 261
  • 19 Oct 2023
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