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Topic Review
Pathogenesis of Adenomyosis
Cancer arising from adenomyosis is very rare, with transformation occurring in only 1% of cases and in older individuals. Adenomyosis, endometriosis and cancers may share a common pathogenic mechanism that includes hormonal factors, genetic predisposition, growth factors, inflammation, immune system dysregulation, environmental factors and oxidative stress. Endometriosis and adenomyosis both exhibit malignant behaviour. The most common risk factor for malignant transformation is prolonged exposure to oestrogens. The golden standard for diagnosis is histopathology. Colman and Rosenthal emphasised the most important characteristics in adenomyosis-associated cancer.
  • 288
  • 25 Jun 2023
Topic Review
Diabetic Foot Ulcers: Promising Biomaterials for Wound Dressings
Diabetic Foot Ulcers (DFUs) are deep tissue lesions on the lower extremities, mainly associated with sustained hyperglycemia, peripheral neuropathy, and peripheral arterial disease (PAD). Globally, a lower limb is amputated every 20 to 30 s, with DFU being responsible for 85 to 95% of cases. Furthermore, individuals with DFUs typically display an increased risk of mortality, more than the double risk of those with DM without a DFU.
  • 662
  • 25 Jun 2023
Topic Review
The Distinction between Constitutional SGA and FGR Infants
Data regarding the nutritional management of preterm small for gestational age (SGA) infants are scarce. In the recent report of ESPGHAN, the recommended energy for very preterm infants during hospitalization has been increased, yet this may not fit the needs of all preterm infants. It is important to distinguish fetal growth-restricted (FGR) infants from constitutional SGA infants, as well as preterm SGA from preterm AGA infants, since they may have different nutritional needs. Preterm FGR infants, and specifically infants < 29 weeks’ gestation, accumulate nutrient deficits due to intrauterine malnutrition, prematurity, morbidities, delayed initiation of feeding, and feeding intolerance. Therefore, these infants may need more aggressive nutrition for optimal catch-up growth and neurologic development. 
  • 681
  • 25 Jun 2023
Topic Review
Vitamin D and Endothelial Function
Vitamin D deficiency (VDD) and erectile dysfunction (ED) heavily burden the male population. The higher prevalence of both conditions in the elderly suggests a possible relationship between the two conditions. In addition, in vitro, animal, and human studies have revealed several mechanisms that may relate VDD to ED. The main mechanism by which vitamin D might exert its action on sexual function appears to be through the regulation of endothelial function. Indeed, VDD correlates with several markers of endothelial function. The action of vitamin D on the endothelium would be exercised both indirectly through its intervention in inflammatory processes and through the production of oxygen free radicals, and directly through the regulation of vascular stiffness, the production of nitric oxide, and the regulation of vessel permeability.
  • 369
  • 25 Jun 2023
Topic Review
Lateral Humeral Condyle Fractures in Pediatric Patients
Lateral humeral condyle fractures are frequently seen in pediatric patients and have a high risk of unfavorable outcomes. A fall on the outstretched arm with supination of the forearm is the most common trauma mechanism. A physical examination combined with additional imaging will confirm the diagnosis. Several classifications have been described to categorize these fractures based on location and comminution. Treatment options depend on the severity of the fracture and consist of immobilization in a cast, closed reduction with percutaneous fixation, and open reduction with fixation. These fractures can lead to notable complications such as lateral condyle overgrowth, surgical site infection, pin tract infections, stiffness resulting in decreased range of motion, cubitus valgus deformities, ‘fishtail’ deformities, malunion, non-union, avascular necrosis, and premature epiphyseal fusion. Adequate follow-up is therefore warranted.
  • 296
  • 25 Jun 2023
Topic Review
History of Programmed Death-Ligand 1 in Malignant Melanoma
Programmed death-ligand 1 (PD-L1) is the primary ligand of the receptor programmed death-1 (PD-1) which is constitutively expressed or activated in myeloid, lymphoid (T, B and NK), normal epithelial cells, and cancer. The PD-1/PD-L1 interaction is crucial for the physiological development of immunological tolerance but also in the development of the cancer. Among these, malignant melanoma represents a tumour in which the immunohistochemical expression of PD-L1 is important to guide future therapeutic choices based on the presence/absence of expression.
  • 235
  • 25 Jun 2023
Topic Review
ESAT-6 a Major Virulence Factor of Mycobacterium tuberculosis
Mycobacterium tuberculosis (Mtb) virulence relies on its ability to manipulate host macrophages, where it establishes intracellular niches to cross mucosal barriers and avoid pathogen destruction. First, Mtb subverts the endocytic pathway, preventing phagolysosome fusion and proteolytic digestion. Second, it activates innate immune responses to induce its transmigration into the lung parenchyma. There, infected macrophages attract more permissive cells, expanding intracellular niches. Mtb induces the adaptive responses that stimulate its containment and encourage a long life inside granulomas. Finally, the pathogen induces necrotic cell death in macrophages, granuloma destruction, and lung cavitation for transmission. Common to all these events is the major virulence factor: the “early secreted antigenic target of 6 kDa” (ESAT-6, also called EsxA). The loss or gain of mycobacterial virulence is closely linked to the ability of mycobacteria to produce and secrete ESAT-6, and the extension of virulence is correlated with the amount of protein secreted. ESAT-6 secretion from the bacilli requires both the expression of the esx-1 locus for the type VII secretion apparatus and the transcription of both the ESAT-6 gene (esxA) and the culture filtrate protein 10 (CFP-10) gene (esx-B) contained in the RD1 region of the genome. In addition, it requires the protein EspA, which is not encoded in the esx-1 locus but in the extended espACD operon adjacent to RD8. All species and strains deleted in the esx-1 locus, the internal RD1 region, or the esx-1 extended locus espACD exhibit an attenuated phenotype. Mutants with deletions on ESX-1 of Mtb are attenuated in virulence, translating into reduced survival of mycobacteria in cultured macrophages or in experimental animal models of TB. Curiously, the saprophyte species M. smegmatis (Ms) also encodes for an ESX-1 apparatus; however, it does not appear to confer Ms virulence capabilities, as demonstrated by its inability to survive in human macrophages or in amoeba in the environment. Predatory amoeba may have contributed to the evolutionary pressure that selected mycobacterial pathogens for intracellular survival. 
  • 399
  • 25 Jun 2023
Topic Review
Uric Acid Electroanalysis
Uric acid is a metabolic product that results from degradation of purines in the liver. Usually, uric acid is identified from biological fluids, human serum and urine through conventional methods, such as spectroscopy, chromatography, electrochemistry, membrane capillary electrophoresis and spectrophotometric methods, including uricase enzymatic reactions. Importantly, uric acid determination opens the possibility of early intervention in cases of hyperuricemia and preventing the degradation of renal function.
  • 550
  • 25 Jun 2023
Topic Review
Celiac Disease and Type 1 Diabetes Mellitus
Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Type 1 diabetes mellitus (T1DM), an autoimmune disease, is caused by insulin deficiency due to destruction of the insulin-producing pancreatic beta cells.
  • 534
  • 25 Jun 2023
Topic Review
Cerebral Sinus Vein Thrombosis and Gender
Cerebral sinus venous thrombosis (CSVT) is a relatively rare acute disorder of cerebral circulation, but it can potentially be associated with serious sequelae and a poor prognosis. The neurological manifestations associated with it are often not adequately taken into consideration given the extreme variability and nuances of its clinical presentation and given the need for radiological methods suitable for this type of diagnosis. CSVT is usually more common in women, but so far there are little data available in the literature on sex-specific characteristics regarding this pathology. CSVT is the result of multiple conditions and is therefore to be considered a multifactorial disease where at least one risk factor is present in over 80% of cases.
  • 221
  • 25 Jun 2023
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