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Topic Review
Biography
Topic Review
Treatment of Cutaneous Melanoma
Cutaneous melanoma is a public health problem. Pathogenic pathways and the tumor microclimate are key to the development of therapeutic methods. Revolutionary therapies like targeted therapy and immune checkpoint inhibitors are starting to replace traditional therapeutic methods. Targeted therapy aims at a specific molecule in the pathogenic chain to block it, stopping cell growth and dissemination. The main function of immune checkpoint inhibitors is to boost cellular immunity in order to combat cancer cells.
111
07 Feb 2024
Topic Review
Treatment of Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia (CAH) is a common genetic disorder in endocrinology, especially its milder clinical presentation, often caused by a partial or total deficiency of the 21-hydroxylase enzyme located in the adrenal cortex. CAH is characterized by the overproduction of androgen, along with variable degrees of cortisol and aldosterone deficiency. The age at diagnosis can provide some information about underlying mutations, with those diagnosed at birth/early infancy more likely to have severe enzymatic defects, which may include adrenal insufficiency, sexual development disorders, short stature in adulthood, hirsutism, and a higher risk for metabolic syndrome and infertility. Non-classic CAH, a milder form of CAH, is usually manifested later in life and is a common differential diagnosis of Polycystic Ovary Syndrome and should be actively evaluated during initial studies of clinical or biochemical hyperandrogenism.
532
05 May 2023
Topic Review
Treatment of Cisplatin/Platinum-Ineligible Metastatic Urothelial Carcinoma
Metastatic urothelial cancer (mUC) is an aggressive malignancy with limited treatment options. Cisplatin-based chemotherapy has been the standard of care in metastatic urothelial cancer (mUC). However, many patients with comorbidities cannot receive cisplatin or its alternative, carboplatin. ‘Cisplatin-ineligible’ and ‘platinum-ineligible’ patients lacked effective therapy options. However, the combination of enfortumab vedotin (EV), an antibody–drug conjugate targeting Nectin-4, with pembrolizumab (P), an antibody targeting the programmed death-1 (PD-1) immune checkpoint, is changing the status quo of frontline mUC treatment, with potential synergy seen in the EV-103 and EV-302 clinical trials.
239
22 Mar 2024
Topic Review
Treatment of Chronic Pain
The International Association for Study of Pain defines it as “an unpleasant sensory and emotional experience associated with or resembling that associated with, actual or potential tissue damage” .
577
30 Jun 2022
Topic Review
Treatment of Cardiovascular Disease in Rheumatoid Arthritis
Rheumatoid arthritis (RA) carries significant risk for atherosclerotic cardiovascular disease (ASCVD). Traditional ASCVD risk factors fail to account for this accelerated atherosclerosis. Shared inflammatory pathways are fundamental in the pathogenesis of both diseases. Considering the impact of RA in increasing cardiovascular morbidity and mortality, the characterization of therapies encompassing both RA and ASCVD management merit high priority. Despite little progress, several drugs discussed here promote remission and or lower rheumatoid disease activity while simultaneously conferring some level of atheroprotection. Methotrexate, a widely used disease-modifying drug used in RA, is associated with significant reduction in cardiovascular adverse events. MTX promotes cholesterol efflux from macrophages, upregulates free radical scavenging and improves endothelial function. Likewise, the sulfonamide drug sulfasalazine positively impacts the lipid profile by increasing HDL-C, and its use in RA has been correlated with reduced risk of myocardial infraction.
573
20 Jan 2022
Topic Review
Treatment of Canine Hemangiosarcoma
Hemangiosarcoma is a mesenchymal neoplasm that originates in the endothelial cells of blood vessels. According to the location of origin, they can be classified as non-visceral and visceral types. Hemangiosarcoma can be very aggressive and metastasize to distant organs.
869
07 Apr 2023
Topic Review
Treatment of Brain Metastases
Brain metastases are the most common brain tumor and frequently originate from primary lung cancer, breast cancer, and melanoma. Brain metastases account for a disproportionately high percentage of morbidity and mortality among patients with cancer, with dismal 2- and 5-year survival rates of 8.1 and 2.4% after diagnosis. There are an estimated 200,000 new brain metastases diagnoses per year, and this number is projected to increase as systemic treatment modalities and imaging techniques improve. Despite the increasing prevalence of brain metastases, there are limited treatment options. While radiotherapy (RT) is a mainstay to treat brain metastases, systemic therapies have historically demonstrated limited ability to penetrate the blood–brain barrier (BBB). Immune checkpoint inhibitors (ICIs) have emerged as a promising treatment option for patients with brain metastases.
364
20 Sep 2022
Topic Review
Treatment of BRAF-Mutant Melanoma
Melanoma is the most lethal form of skin cancer. Melanoma is usually curable with surgery if detected early, however, treatment options for patients with metastatic melanoma are limited and the five-year survival rate for metastatic melanoma had been 15–20% before the advent of immunotherapy. Treatment with immune checkpoint inhibitors has increased long-term survival outcomes in patients with advanced melanoma to as high as 50% although individual response can vary greatly. A mutation within the MAPK pathway leads to uncontrollable growth and ultimately develops into cancer. The most common driver mutation that leads to this characteristic overactivation in the MAPK pathway is the B-RAF mutation. Current combinations of BRAF and MEK inhibitors that have demonstrated improved patient outcomes include dabrafenib with trametinib, vemurafenib with cobimetinib or encorafenib with binimetinib. Treatment with BRAF and MEK inhibitors has met challenges as patient responses began to drop due to the development of resistance to these inhibitors which paved the way for development of immunotherapies and other small molecule inhibitor approaches to address this. Resistance to these inhibitors continues to push the need to expand our understanding of novel mechanisms of resistance associated with treatment therapies.
342
21 Jun 2021
Topic Review
Treatment of Bacterial Infections in T2DM Patients
Type 2 diabetes mellitus (T2DM) is the metabolic disease with the highest morbidity rates worldwide. The condition is characterized by hyperglycemia, insulin resistance, hyperlipidemia, and chronic inflammation, among other detrimental conditions. These decrease the efficiency of the immune system, leading to an increase in the susceptibility to bacterial infections. Maintaining an optimal blood glucose level is crucial in relation to the treatment of T2DM, because if the level of this carbohydrate is lowered, the risk of infections can be reduced.
432
27 Apr 2023
Topic Review
Treatment of Amblyopia
Amblyopia is the most common cause of monocular poor vision affecting up to 3.7% of the global population. Classically, the first step in treatment has been optical correction, followed by patching and/or pharmacological treatment. However, this is an evolving scenario, since researchers and clinicians are interested in new binocular treatments due to the increasing development of new technologies. In this article main, current binocular treatments as Dig Rush, falling blocks, I-BiT, Occlu-tab, Vivid Vision, and movies are reviewed for binocular amblyopia management.
594
05 Jul 2021
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