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Topic Review
Metformin in Diabetes Mellitus&Ovarian Cancer
Since multiple reports established an association between diabetes mellitus and various cancers, emerging studies have surfaced to understand the effects of metformin as an anti-cancer agent. Although there was previous, but conflicting evidence, of a relationship between diabetes and ovarian cancer (OvCa), recent studies have supported this association. The mechanism of cancer development in patients with diabetes is likely to involve hyperglycemia, hyperinsulinemia, chronic inflammation, reactive oxygen species, regulation of cellular homeostasis, and activation of various pathways that lead to tumor cell proliferation. Preclinical evidence indicating that metformin, a medication commonly used to treat type 2 diabetes mellitus, may protect against OvCa. Metformin exerts anti-cancer properties by activating the MAPK pathway, inhibiting the PI3K/AKT/mTOR pathway, increasing tumor suppressor genes, inducing G2/M cycle arrest, and various other processes. Several studies have shown the efficacy of metformin as an adjunct with standard chemotherapeutic agents due to its synergistic effects on OvCa cells.
  • 422
  • 30 Aug 2021
Topic Review
Immunotherapeutics in Gastric Cancer
Immune checkpoint inhibitors have revolutionized the treatment landscape for many solid tumors. Amongst gastric cancer subtypes, tumors with microsatellite instability and Epstein Barr Virus positive tumors provide the strongest rationale for responding to immunotherapy. Various predictive biomarkers such as mismatch repair status, programmed death ligand 1 expression, tumor mutational burden, assessment of tumor infiltrating lymphocytes and circulating biomarkers have been evaluated. However, results have been inconsistent due to different methodologies and thresholds used. Clinical implementation therefore remains a challenge. The role of immune checkpoint inhibitors in gastric cancer is emerging with data from monotherapy in the heavily pre-treated population already available and studies in earlier disease settings with different combinatorial approaches in progress. Immune checkpoint inhibitor combinations with chemotherapy (CT), anti-angiogenics, tyrosine kinase inhibitors, anti-Her2 directed therapy, poly (ADP-ribose) polymerase inhibitors or dual checkpoint inhibitor strategies are being explored.
  • 420
  • 14 Apr 2021
Topic Review
Qualitative Evidence for Return-to-Work
Chronic musculoskeletal pain (CMSP) (i.e., pain duration >3 months) such as chronic neck/shoulder and back pain or generalized widespread pain (including fibromyalgia (FM)) has a prevalence from 10.4% to 20% among adults.
  • 419
  • 19 Apr 2021
Topic Review
Metformin and Metabolism in Cancer Cells
Metformin has been a long-standing prescribed drug for treatment of type 2 diabetes (T2D) and its beneficial effects on virus infection, autoimmune diseases, aging and cancers are also recognized. Metformin modulates the differentiation and activation of various immune-mediated cells such as CD4+ and CD+8 T cells. The activation of adenosine 5′-monophosphate-activated protein kinase (AMPK) and mammalian target of rapamycin complex 1 (mTORC1) pathway may be involved in this process.
  • 419
  • 30 Jan 2023
Topic Review
Water Intoxication
Water intoxication, also known as water poisoning, hyperhydration, overhydration, or water toxemia, is a potentially fatal disturbance in brain functions that results when the normal balance of electrolytes in the body is pushed outside safe limits by excessive water intake. Under normal circumstances, accidentally consuming too much water is exceptionally rare. Nearly all deaths related to water intoxication in normal individuals have resulted either from water-drinking contests, in which individuals attempt to consume large amounts of water, or from long bouts of exercise during which excessive amounts of fluid were consumed. In addition, water cure, a method of torture in which the victim is forced to consume excessive amounts of water, can cause water intoxication. Water, just like any other substance, can be considered a poison when over-consumed in a brief period of time. Water intoxication mostly occurs when water is being consumed in a high quantity without adequate electrolyte intake. Excess of body water may also be a result of a medical condition or improper treatment; see "hyponatremia" for some examples. Water is considered one of the least toxic chemical compounds, with an LD50 of over 150 ml/kg in rats.
  • 418
  • 07 Nov 2022
Topic Review
Cerebral/Renal Salt Wasting in Hyponatremia
There is a tendency to treat all patients with hyponatremia because of common subtle symptoms that include unsteady gait that lead to increased falls and bone fractures and can progress to mental confusion, irritability, seizures, coma and even death. There is a new approach that is superior to the ineffectual volume approach. Determination of fractional excretion (FE) of urate has simplified the diagnosis of a reset osmostat, Addison’s disease, edematous causes such as congestive heart failure, cirrhosis and nephrosis, volume depletion from extrarenal salt losses with normal renal tubular function and the difficult task of differentiating the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) from cerebral/renal salt wasting (C/RSW). SIADH and C/RSW have identical clinical and laboratory parameters but have diametrically opposite therapeutic goals of water-restricting water-loaded patients with SIADH or administering salt water to dehydrated patients with C/RSW.
  • 418
  • 27 Feb 2023
Topic Review
Behcet’s Disease
Behcet’s disease (BD) is a multisystemic inflammatory disorder characterized by a range of manifestations, such as recurrent oral ulcers, genital ulcers, arthritis, vasculitis, and skin lesions. The age of onset of BD is usually 30–40 years. 
  • 417
  • 28 Apr 2021
Topic Review
Microbeam Radiotherapy
Melanoma is the deadliest type of skin cancer, due to its invasiveness and limited treatment efficacy. The main therapy for primary melanoma and solitary organ metastases is wide excision. Adjuvant therapy, such as chemotherapy and targeted therapies are mainly used for disseminated disease. Radiotherapy (RT) is a powerful treatment option used in more than 50% of cancer patients, however, conventional RT alone is unable to eradicate melanoma. Its general radioresistance is attributed to overexpression of repair genes in combination with cascades of biochemical repair mechanisms. A novel sophisticated technique based on synchrotron-generated, spatially fractionated RT, called Microbeam Radiation Therapy (MRT), has been shown to overcome these treatment limitations by allowing increased dose delivery. With MRT, a collimator subdivides the homogeneous radiation field into an array of co-planar, high-dose microbeams that are tens of micrometres wide and spaced a few hundred micrometres apart. Different preclinical models demonstrated that MRT has the potential to completely ablate tumours, or significantly improve tumour control while dramatically reducing normal tissue toxicity.
  • 417
  • 09 Aug 2021
Topic Review
SARS-CoV-2 in Thyroid Disorders
A properly functioning thyroid gland is crucial for health, influencing growth, neuronal development, reproduction and as a key regulator of energy metabolism, although thyroid disorders/diseases are extremely common and affect 200 million people worldwide. Viral infection may represent one of the major environmental factors related to common thyroid disorders, including subacute thyroiditis (SAT), nonthyroidal illness syndrome (NTIS) and autoimmune thyroid diseases (AITDs) including Graves’ disease (GD) and Hashimoto’s thyroiditis (HT).
  • 415
  • 08 May 2023
Topic Review
Acupressure for Managing Osteoarthritis
Osteoarthritis (OA) is a common joint disease, which is linked to joint degeneration, loss of cartilage, and alterations of the subchondral bone, and mainly affects the hands, knees, and hips. OA is a highly predominant health condition, which has affected over 260 million people worldwide, and it is becoming even more common due to the combined effects of aging and obesity. OA is even more problematic as it is associated with pain, disability, and personal and economic burden. This review aims to evaluate the effectiveness of acupressure as a treatment method for osteoarthritis. 
  • 413
  • 18 May 2021
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