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Topic Review
GLP-1 and DPP-4  Applied Gestational Diabetes Mellitus
Gestational diabetes mellitus (GDM) is a disorder defined as carbohydrate intolerance that manifests during the second or third trimester of pregnancy. To prevent them, it is important to keep glucose levels under control. As much as 15–30% of GDM patients will require treatment with insulin, metformin, or glyburide. With that in mind, it is crucial to keep searching for novel and improved pharmacotherapies. Nowadays, there are ongoing studies investigating the use of other groups of drugs that have proven successful in the treatment of type 2 diabetes mellitus (T2DM). Glucagon-like peptide-1 (GLP-1) receptor agonist and dipeptidyl peptidase-4 (DPP-4) inhibitor are among the drugs targeting the incretin system and are currently receiving significant attention. GLP-1 is a peptide that is produced through the proteolysis of proglucagon, a protein expressed in L cells in the intestinal mucosa, α cells of the pancreas, as well as in the nucleus of the solitary tract (NTS) in the brainstem. GLP-1 has access to a specific GLP-1 receptor (GLP-1R) that is expressed in a wide range of target tissues. It is secreted mainly after the ingestion of glucose, lipids, or mixed meals, and increases glucose-stimulated insulin secretion at physiological plasma concentrations, which meets all the criteria for an incretin hormone.
  • 88
  • 25 Sep 2023
Topic Review
Therapeutic Applications of Probiotics
Probiotics are live microorganisms that induce health benefits to the host. Prebiotics, such as inulin and fructooligosaccharides, are nondigestible food components that promote the growth of beneficial bacteria in the colon, whereas synbiotics are a mixture of live microorganisms with substrates that are selectively utilized by host which can provide even more benefits than prebiotics alone.
  • 177
  • 25 Sep 2023
Topic Review
Achieving Optimum Clinical Outcomes with Vitamin D
Musculoskeletal benefits of vitamin D include calcium homeostasis, bone mineralization, etc., through its hormonal actions. This requires serum 25(OH)D less than 20 ng/mL. In contrast, many other tissues require above 30 or 40 ng/mL steady-state concentrations. To reduce infections, autoimmune diseases, cancer, and all-cause mortality require a minimum level of 50 ng/mL. Vitamin D is an economical and widely available (generic) nutrient obtained over the counter without a prescription. At the recommended doses, vitamin D does not cause any adverse effects. Disease prevention and minimizing complications and premature deaths can be achieved by maintaining serum 25(OH)D concentrations between 50 and 80 ng/mL. This costs less than 0.01% of the cost of one day of hospitalization.
  • 327
  • 21 Sep 2023
Topic Review
Glucocorticoid-Induced Osteoporosis (GIOP)
In a physiological state, glucocorticoids stimulate mature osteoblasts to produce Wnt proteins functioning as signaling molecules, causing a Wnt/β-catenin cascade to be activated. This signaling cascade affects mesenchymal progenitor cells, and has a positive effect on their differentiation into osteoblasts instead of chondrocytes or adipocytes. Glucocorticoids are the most widely used anti-inflammatory drug around the world. Despite their excellent effect in managing many acute inflammatory diseases and autoimmune disorders, the usage of glucocorticoids has been limited due to substantial adverse effects. One of the most well-known side effects is osteoporosis, which further induces bone fracture and other musculoskeletal problems.
  • 248
  • 18 Sep 2023
Topic Review
Role of Lipoprotein(a) in Arterial Hypertension
Elevated plasma lipoprotein(a) [Lp(a)] is a relatively common and highly heritable trait conferring individuals time-dependent risk of developing atherosclerotic cardiovascular disease (CVD).
  • 149
  • 11 Sep 2023
Topic Review
Substantia Nigra Imaging in Parkinson
Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms due to the degeneration of the pars compacta of the substantia nigra (SNc) with dopaminergic denervation of the striatum. Although the diagnosis of PD is principally based on a clinical assessment, great efforts have been expended over the past two decades to evaluate reliable biomarkers for PD. Among these biomarkers, magnetic resonance imaging (MRI)-based biomarkers may play a key role. Conventional MRI sequences are considered by many in the field to have low sensitivity, while advanced pulse sequences and ultra-high-field MRI techniques have brought many advantages, particularly regarding the study of brainstem and subcortical structures. Nowadays, nigrosome imaging, neuromelanine-sensitive sequences, iron-sensitive sequences, and advanced diffusion weighted imaging techniques afford new insights to the non-invasive study of the SNc. 
  • 762
  • 07 Sep 2023
Topic Review
Triple Overlap Syndrome (OSAHS-COPD-CHF)
Obstructive sleep apnea-hypopnea syndrome (OSAHS) and chronic obstructive pulmonary disease (COPD) are independently linked to an increase in cardiovascular disease (CVD). Only a few studies have been published linking the association between overlap syndrome and congestive heart failure (CHF). It is becoming increasingly clear through research that there is a strong connection between OSA, COPD, and CHF. 
  • 847
  • 06 Sep 2023
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.
  • 374
  • 05 Sep 2023
Topic Review
Diagnostic and Therapeutic Approaches to Temporomandibular Dysfunction
Temporomandibular dysfunction (TMD) is a burgeoning area of study within the dental field. TMD is caused by abnormalities in the temporomandibular joint or muscles of mastication and can lead to pain, loss of function, and other complications.
  • 148
  • 29 Aug 2023
Topic Review
Non-Pharmacological Interventions for Pain Management in Hemodialysis
Acupuncture demonstrated considerable promise as a benign and efficacious supplementary therapy for managing pain, enhancing functional capacity and muscular strength, lessening symptoms of restless leg syndrome and uremic pruritus, and bettering the quality of life (QOL) of patients on hemodialysis. Additional investigations are imperative to confirm these results and define the ideal parameters for treatment. Cognitive behavioral therapy also exhibited the potential to ameliorate diverse facets of wellness in hemodialysis patients, including social support, QOL, and mental health outcomes. Cognitive behavioral therapy (CBT) proved successful in attenuating depressive symptom severity, enhancing therapy adherence, and diminishing depression. Internet-based CBT could potentially enhance the accessibility and effectiveness of these interventions for this patient population. Relaxation techniques, encompassing progressive muscle relaxation, guided imagery, deep breathing exercises, and mindfulness meditation, appear to hold potential in managing pain, fatigue, stress, and sleep patterns, as well as in promoting well-being and QOL for hemodialysis patients. Emerging as an innovative immersive technology, virtual reality has demonstrated potential benefits in pain management for individuals undergoing hemodialysis.
  • 323
  • 23 Aug 2023
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