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Topic Review
Diagnosis and Management of Acute Liver Failure
Acute liver failure (ALF) is a rare and specific form of severe hepatic dysfunction characterized by coagulopathy and hepatic encephalopathy in a patient with no known liver disease. ALF carries a high morbidity and mortality. Careful attention should be given to hemodynamics and metabolic parameters along with the active surveillance of infections. Timely transfer and supportive management are important in an intensive care unit in a liver transplant center. Identifying patients who will and will not improve with medical management and may need emergent liver transplantation is critical.
  • 109
  • 14 Dec 2023
Topic Review
Arrhythmogenic Cardiomyopathy across the Spectrum of Ventricular Involvement
Improved disease recognition through family screening and increased life expectancy with appropriate sudden cardiac death prevention has increased the burden of heart failure in arrhythmogenic cardiomyopathy (ACM). Heart failure management guidelines are well established but primarily focus on left ventricle function. A significant proportion of patients with ACM have predominant or isolated right ventricle (RV) dysfunction. Management of RV dysfunction in ACM lacks evidence but requires special considerations across the spectrum of heart failure regarding the initial diagnosis, subsequent management, monitoring for progression, and end-stage disease management. 
  • 185
  • 14 Dec 2023
Topic Review
Chronic Orofacial Pain
In exploring chronic orofacial pain (COFP), it's very important to highlight its global impact on life quality and critiques current diagnostic systems, including the ICD-11, ICOP, and ICHD-3, for their limitations in addressing COFP’s complexity. The mismanagement of pain not only leads to severe physical, psychological, and social repercussions but also incurs substantial economic costs, both in terms of healthcare expenditure and lost productivity.
  • 105
  • 14 Dec 2023
Topic Review
General Characteristics and Nephroprotective Properties of Salvia Genus
The study of medicinal plants is important, as they are the natural reserve of potent biologically active compounds. With wide use in traditional medicine and the inclusion of several species (as parts and as a whole plant) in pharmacopeia, species from the genus Salvia L. are known for the broad spectrum of their biological activities. Studies suggest that these plants possess antioxidant, anti-inflammatory, antinociceptive, anticancer, antimicrobial, antidiabetic, antiangiogenic, hepatoprotective, cognitive and memory-enhancing effects. Phenolic acids, terpenoids and flavonoids are important phytochemicals, which are primarily responsible for the medicinal activity of Salvia L.
  • 419
  • 14 Dec 2023
Topic Review
Microbiome-Directed Therapies
Loss of commensal microbiota and excessive growth of potentially pathogenic bacteria are the main features of the gut microbiota in critically ill adult patients. Gut microbiota imbalance can increase the risk of secondary infection, immunosuppression, and even organ dysfunction, leading to an increased incidence of opportunistic infections and sepsis, aggravated various target organ damage, and worsened patient condition. Additionally, even after recovery from sepsis, the slow recolonization of patients’ normal microbiota may lead to long-term immunosuppression and poor prognosis. Therefore, different strategies related to the gut microbiota, such as using probiotics and prebiotics alone or in combination (synthetic preparations,) have been proposed in order to prevent the further growth of pathogens and improve the outcomes of critically ill patients.
  • 210
  • 14 Dec 2023
Topic Review
Radiotherapy of Orbital and Ocular Adnexa Lymphoma
Orbital and ocular adnexa lymphomas are rare neoplasms confined to the orbital region. The prognosis is generally favorable, with a high proportion of localized disease, indolent clinical course, prolonged disease-free intervals, and low lymphoma-related mortality rate. 
  • 313
  • 14 Dec 2023
Topic Review
Vasopressin-Related Possible Therapies in Autism
Autism spectrum disorder (ASD) is rather common, presenting with prevalent early problems in social communication and accompanied by repetitive behavior. There is no cure for ASD, and there is currently no medication to treat it. The medications are prescribed mainly to treat self-injury, inability to focus, anxiety and depression (SSRIs), aggression (alpha-2 adrenergic agonist, Clonidine) and hyperactivity (dopamine and noradrenaline stimulant methylphenidate, Ritalin). Strategies to treat the core symptoms of ASD are directed to correct synaptic dysfunctions, abnormalities in central VP, OT and serotonin neurotransmission, and neuroinflammation. 
  • 386
  • 14 Dec 2023
Topic Review
Biosimilar Agents
A biosimilar is a biological product highly similar to and interchangeable with an already approved reference product. Innovations in computer-aided discovery for biosimilar agents involve several key approaches. Structural bioinformatics and molecular docking techniques, including homology modeling and molecular dynamics simulations, aid in understanding the structure-function relationships. In silico screening and virtual high-throughput screening, powered by database mining and predictive modeling, expedite the identification of potential biosimilar candidates. Machine learning and artificial intelligence contribute by analyzing large datasets to predict success probabilities and integrating diverse data sources. Immunogenicity prediction tools assess potential immune responses, while network pharmacology and quantitative systems pharmacology provide a holistic understanding of biosimilar effects. Optimization algorithms play a role in formulating biosimilars for desired properties. This dynamic field continues to evolve, with regular updates reflecting the latest advancements in computational tools for biosimilar discovery.
  • 185
  • 13 Dec 2023
Topic Review
Carbohydrate Counting, Mixed Meals, and Food Glycemic-Index Management
Achieving optimal glucose control in individuals with type 1 diabetes (T1DM) continues to pose a significant challenge. While continuous insulin infusion systems have shown promise as an alternative to conventional insulin therapy, there remains a crucial need for greater awareness regarding the necessary adaptations for various special circumstances. Nutritional choices play an essential role in the efficacy of diabetes management and overall health status for patients with T1DM. Factors such as effective carbohydrate counting, assessment of the macronutrient composition of meals, and comprehending the concept of the glycemic index of foods are paramount in making informed pre-meal adjustments when utilizing insulin pumps.
  • 162
  • 13 Dec 2023
Topic Review
Mechanistic Basis for Autophagy in Diabetic Kidney Disease
Diabetic kidney disease (DKD), or diabetic nephropathy (DN), is a common but severe complication in diabetic patients. The disorder mainly consists of persistent proteinuria with progressive worsening of renal function, and can ultimately cause irreversible kidney damage. Studies have provided new insights into the connection between autophagy, a physiological metabolic process known to maintain cellular homeostasis, and the pathophysiological pathways of DKD. Typically, autophagic activity plays a role in DKD progression mainly by promoting an inflammatory response to tissue damage, while both overactivated and downregulated autophagy worsen disease outcomes in different stages of DKD. 
  • 191
  • 13 Dec 2023
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