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Topic Review
Management of Lung Toxicity with T-DXd in Canada
Ongoing advances in precision cancer therapy have increased the number of molecularly targeted and immuno-oncology agents for a variety of cancers, many of which have been associated with a risk of pulmonary complications, among the most concerning being drug-induced interstitial lung disease/pneumonitis (DI-ILD). As the number of patients undergoing treatment with novel anticancer agents continues to grow, DI-ILD is expected to become an increasingly significant clinical challenge. Trastuzumab deruxtecan (T-DXd) is an antibody–drug conjugate targeting human epidermal growth factor receptor 2 that is gaining widespread use in the metastatic breast cancer setting and is undergoing exploration for other oncologic indications. ILD/pneumonitis is an adverse event of special interest associated with T-DXd, which has potentially fatal consequences if left untreated and allowed to progress. When identified in the asymptomatic stage (grade 1), T-DXd-related ILD can be monitored and treated effectively with the possibility of treatment continuation. Delayed diagnosis and/or treatment, however, results in progression to grade 2 or higher toxicity and necessitates immediate and permanent discontinuation of this active agent. Strategies are, therefore, needed to optimize careful monitoring during treatment to ensure patient safety and optimize outcomes.
  • 157
  • 19 Sep 2023
Topic Review
Long-Term Care Insurance
Long-term care insurance is insurance that pays for expenses incurred by individuals who are unable to care for themselves due to old age, illness, or disability, as well as individuals who need to be accompanied to medical appointments at home or in a nursing home. Long-term care insurance falls under the category of health insurance, where the subject matter is an individual's physical health condition. Usually the period of care is very long, it may be six months, one year, several years or even ten years or more. The point of care is to maintain the individual's physical functioning for as long as possible rather than primarily for the purpose of healing, and long term care insurance serves as a financial reimbursement for the cost of care. Long-term care insurance primarily pays for the daily care costs of the elderly, or those caused by illness or disability. It is usually categorized into home care and institutional care. The difference with Medicare is that Medicare primarily covers the cost of medically necessary care, whereas long-term care insurance is primarily used to pay for the cost of general life care and generally does not cover medical interventions
  • 156
  • 19 Jun 2024
Topic Review
Hospital Processes
When thinking about a hospital, we can subdivide it into four main areas: Infrastructure, Outpatient and Emergency, Clinical and Surgical Inpatient, and Diagnosis and Treatment. For each of these areas, this entry can list several subareas and several important processes for providing hospital care.
  • 156
  • 28 Feb 2024
Topic Review
The Process of Plaque Rupture
A warning sign for impending cardiovascular events is not fully established. In the process of plaque rupture, the formation of vulnerable plaque is important, and oxidized cholesterols play an important role in its progression. Furthermore, the significance of vasa vasorum penetrating the medial smooth muscle layer and being rich in atheromatous lesions should be noted. The cardio-ankle vascular index (CAVI) is a new arterial stiffness index of the arterial tree from the origin of the aorta to the ankle. The CAVI reflects functional stiffness, in addition to structural stiffness. The rapid rise in the CAVI means medial smooth muscle cell contraction and strangling vasa vasorum. A rapid rise in the CAVI in people after a big earthquake, following a high frequency of cardiovascular events has been reported. 
  • 153
  • 12 Jan 2024
Topic Review
Health Implications of Whey Protein Consumption
Whey protein (WP), commonly consumed for muscle building and weight loss, has been associated with various health concerns. Significant findings were revealed, such as WP’s potential link to liver and kidney damage, alterations in gut microbiota, increased acne incidence, impacts on bone mass, and emotional and behavioural changes. These findings underscore the complexity of WP’s effects on human health, indicating both beneficial and detrimental outcomes in relation to different posologies in a variety of settings. Be cautious for protein intaking in situations of hepatic and renal compromised functions, as well as in acne susceptibility, while possible beneficial effects can be achieved for the intestinal microbiota, humoral and behavioural level, and finally bone and muscle mass in elderly. The importance of balanced WP consumption and call for more in-depth research to understand its long-term health effects were emphasized. Health professionals and individuals considering WP supplementation should be aware of these potential risks and approach its use with informed caution.
  • 151
  • 05 Feb 2024
Topic Review
Milk-Derived Antiviral Peptides Targeting Zoonotic Viruses
Animals often serve as reservoirs for viral zoonoses, diseases transmissible from animals to humans. While zoonotic viral diseases have been present in human populations since the inception of agricultural practices, they have gained increasing prominence as a global public health concern, particularly with recent epidemics like SARS-CoV-2 (COVID-19). Some of these diseases are categorized as “emerging infectious diseases” due to their newfound recognition or significant changes in their range and epidemiology. Notable zoonotic diseases include influenza, Ebola virus, West Nile virus, emerging coronaviruses, monkeypox, rabies, Zika, and Lyme disease. Six out of every ten infectious diseases in humans are zoonotic, with many being viral. Therefore, it is imperative to enhance our capabilities to prevent and respond to these diseases, adopting a One Health approach. Finding new therapies and ways to prevent viral zoonoses is just as important as increasing efforts on surveillance and early detection, and with the rising amount of research demonstrating the potential of bioactive peptides produced from milk as antivirals, a vital opportunity arises to assess their usage in viral diseases with a focus on One Health. Indeed, several peptides derived from milk protein parents have shown potential for zoonotic viral diseases. 
  • 151
  • 20 Feb 2024
Topic Review
Cervical Cancer Detection
Cervical cancer is a common and preventable disease that poses a significant threat to women’s health and well-being. It is the fourth most prevalent cancer among women worldwide, with approximately 604,000 new cases and 342,000 deaths in 2020, according to the World Health Organization. 
  • 150
  • 08 Oct 2023
Topic Review
Promoting Better Mental Health in People with Autism
The rising prevalence of autism internationally has been accompanied by an increased appreciation of the poorer mental health experienced by people with this condition and also of their family care-givers. In particular, higher incidences of anxiety and depression are reported in high-income nations and these conditions are likely to be under-recognised and under-reported in lower-resourced regions or countries. Mainstream mental health services seem to be ill-equipped to respond adequately to the needs of autistic persons and their care-givers.
  • 149
  • 07 Feb 2024
Topic Review
Virtual Forests Exposure
Numerous studies have confirmed the positive impacts of real forests in areas such as stress relief. However, not everyone can visit forests easily. Virtual technologies offer new ways of experiencing forests for people who are hindered by real-life conditions and provide researchers with a manageable mode of study. 
  • 148
  • 05 Jan 2024
Topic Review
Liquorice Toxicity
Renowned since ancient times for its medical properties, liquorice is nowadays mainly used for flavoring candies or soft drinks. Continuous intake of large amounts of liquorice is a widely known cause of pseudo-hyperaldosteronism leading to hypertension and hypokalemia. These manifestations are usually mild, although in some cases may generate life-threatening complications, i.e., arrhythmias, muscle paralysis, rhabdomyolysis, and coma. 
  • 148
  • 22 Sep 2023
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