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Topic Review
Postoperative Myocardial Infarction after Non-Cardiac Surgery
In patients undergoing major non-cardiac surgery, perioperative myocardial infarction (PMI) is a threatened complication. Every year, not less than 300 million non-cardiac surgery interventions are performed in the world. Perioperative mortality after non-cardiac surgery is estimated at 2% in patients over 45 years of age. Cardiovascular events account for half of these deaths, and most are due to perioperative myocardial infarction (MINS). The diagnosis of postoperative myocardial infarction, before the introduction of cardiac biomarkers, was based on symptoms and electrocardiographic changes and its incidence was largely underestimated. The incidence of MINS when a standard troponin assay is used ranges between 8 and 19% but increases to 20–30% with high-sensitivity troponin assays. Higher troponin values suggesting myocardial injury, both with or without a definite diagnosis of myocardial infarction, are associated with an increase in 30-day and 1-year mortality. 
  • 210
  • 20 Mar 2024
Topic Review
Antioxidant and Anti-Inflammatory Phytochemicals for Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) mainly comprises Crohn’s disease (CD) and ulcerative colitis (UC) and is a group of chronic relapsing disorders characterized by inflammation of the gastrointestinal tract with variable phenotypic expression. Multiple factors have been implicated in the etiology of IBD, including environmental, genetic, microbiological and immunological interactions. However, the exact reasons remain unclear, although substantial progress in elucidating the complexity of IBD manifestation has been made in the past decades. There is clinical overlap of symptoms of CD and UC, including bloody or watery diarrhea, recurrent abdominal pain, tenesmus as well as non-specific systemic symptoms such as fatigue, fever and weight loss. CD can affect various parts of the intestine, i.e., both small and large intestine, while UC is known to affect only the colon. IBD usually follows a lifelong pattern of remissions and flare-ups that impacts the quality of life of patients. The inflammation of the gastrointestinal tract during flare-ups is mediated by neutrophils that release cytokines, enzymes and reactive oxygen species (ROS) leading to damage and even ulceration of the mucosa.
  • 168
  • 19 Mar 2024
Topic Review
Anticancer Effects of α-Linolenic Acid
α-linolenic acid (ALA) belongs to the family of n-3 polyunsaturated fatty acids (n-3 PUFAs) and contains a carbon–carbon double bond on the third carbon atom at the methyl end of the carbon chain. This family of essential fatty acids also includes eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA has gradually attracted increased attention due to its nutritional and medicinal advantages. Studies have shown that ALA exerts beneficial effects on a variety of diseases, including cancer.
  • 102
  • 19 Mar 2024
Topic Review
Mechanisms Linking Hyperuricemia and Kidney Disease Progression
Gout is highly prevalent in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), owing to impaired uric acid excretion. However, treating gout in this population is challenging due to concerns about medication safety and efficacy with reduced kidney function. The 2020 American College of Rheumatology (ACR) guidelines recommend nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and systemic glucocorticoids to treat acute gout flares. These can also be used as prophylaxis when starting urate-lowering therapy (ULT) to prevent flares. For ULT drugs like allopurinol, febuxostat, probenecid, benzbromarone, lesinurad, and pegloticase, key efficacy outcomes per most guidelines include: achieving target serum urate levels (<6 or <5 mg/dL), resolving tophi, reducing gout flares over time, improving quality of life, and radiographic changes. 
  • 149
  • 19 Mar 2024
Topic Review
Radiological Aspects of Sacroiliitis
Sacroiliitis is the inflammation of the sacroiliac joint, the largest axial joint in the human body, contributing to 25% of lower back pain cases. It can be detected using various imaging techniques like radiography, Magnetic Resonance Imaging (MRI), and Computed Tomography (CT) scans. Treatments range from conservative methods to invasive procedures. Recent advancements in artificial intelligence offer precise detection of this condition through imaging. Treatment options range from physical therapy and medications to invasive methods like joint injections and surgery. 
  • 104
  • 19 Mar 2024
Topic Review
SARS-CoV-2 ORF3a Protein as Therapeutic Target against COVID-19
The ORF3a (open reading frame 3a) protein found in SARS-CoV-2, represents a promising target for antiviral treatment due to its multifaceted role in viral pathogenesis, cytokine storms, disease severity, and mortality. ORF3a contributes significantly to viral pathogenesis by facilitating viral assembly and release, essential processes in the viral life cycle, while also suppressing the body’s antiviral responses, thus aiding viral replication. ORF3a also has been implicated in triggering excessive inflammation, characterized by NF-κB-mediated cytokine production, ultimately leading to apoptotic cell death and tissue damage in the lungs, kidneys, and the central nervous system. 
  • 165
  • 19 Mar 2024
Topic Review
MicroRNAs as Potential Graft Rejection or Tolerance Biomarkers
Allograft rejection is a widespread complication in allograft recipients with chronic kidney disease. Undertreatment of subclinical and clinical rejection and later post-transplant problems are caused by an imperfect understanding of the mechanisms at play and a lack of adequate diagnostic tools. Many different biomarkers have been analyzed and proposed to detect and monitor these crucial events in transplant outcomes. In this sense, microRNAs may help diagnose rejection or tolerance and indicate appropriate treatment, especially in patients with chronic allograft rejection. As key epigenetic regulators of physiological homeostasis, microRNAs have therapeutic potential and may indicate allograft tolerance or rejection. However, more evidence and clinical validation are indispensable before microRNAs are ready for clinical prime time.
  • 81
  • 19 Mar 2024
Topic Review
Management of Insomnia in Menopausal Women
Insomnia is one of the major complaints of menopausal women with advancing age and may be complexly related to a variety of causes.
  • 158
  • 19 Mar 2024
Topic Review
Role of Methionine Restriction in Gastric Cancer
Gastric cancer is ranked as the fifth most prevalent cancer globally and has long been a topic of passionate discussion among numerous individuals. However, the incidence of gastric cancer in society has not decreased, but instead has shown a gradual increase in recent years. For more than a decade, the treatment effect of gastric cancer has not been significantly improved. This is attributed to the heterogeneity of cancer, which makes popular targeted therapies ineffective. Methionine is an essential amino acid, and many studies have shown that it is involved in the development of gastric cancer. Our study aimed to review the literature on methionine and gastric cancer, describing its mechanism of action to show that tumor heterogeneity in gastric cancer does not hinder the effectiveness of methionine-restricted therapies. This research also aimed to provide insight into the inhibition of gastric cancer through metabolic reprogramming with methionine-restricted therapies, thereby demonstrating their potential as adjuvant treatments for gastric cancer.
  • 206
  • 18 Mar 2024
Topic Review
Peripheral Arterial Atherosclerotic Disease in Elderly Patients
Atherosclerosis is a generalized and progressive disease. Ageing is a key risk factor for atherosclerosis progression that is associated with the increased incidence of ischemic events in supplied organs, including stroke, coronary events, limb ischemia, or renal failure. Cardiovascular disease is the leading cause of death and major disability in adults ≥ 75 years of age. Atherosclerotic occlusive disease affects everyday activity and quality of life, and it is associated with reduced life expectancy. Although there is evidence on coronary artery disease management in the elderly, there is insufficient data on the management in older patients presented with atherosclerotic lesions outside the coronary territory. Despite this, trials and observational studies systematically exclude older patients, particularly those with severe comorbidities, physical or cognitive dysfunctions, frailty, or residence in a nursing home. This results in serious critical gaps in knowledge and a lack of guidance on the appropriate medical treatment and referral for endovascular or surgical interventions. 
  • 112
  • 18 Mar 2024
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