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Topic review
Updated time: 19 Jan 2021
Submitted by: Anna Löfdahl
Definition: Interstitial lung disease (ILD) encompasses a heterogeneous group of more than 200 conditions, of which primarily idiopathic pulmonary fibrosis (IPF), idiopathic nonspecific interstitial pneumonia, hypersensitivity pneumonitis, ILD associated with autoimmune diseases and sarcoidosis may present a progressive fibrosing (PF) phenotype. Despite different aetiology and histopathological patterns, the PF-ILDs have similarities regarding disease mechanisms with self-sustaining fibrosis, which suggests that the diseases may share common pathogenetic pathways. Previous studies show an enhanced activation of serotonergic signaling in pulmonary fibrosis, and the serotonin (5-HT)2 receptors have been implicated to have important roles in observed profibrotic actions.
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Topic review
Updated time: 04 Feb 2021
Submitted by: Allison B Reiss
Definition: COVID-19 is an RNA virus that has caused a pandemic leading to death and disability on a global scale. The virus gains entry into the cell using host protein angiotensin-converting enzyme-2 (ACE-2) receptor. The viral envelope fuses with the cell membrane through the endosomal pathway, allowing the viral particle to enter the host cell, where it can release its RNA and replicate. After an initial asymptomatic period, common presenting signs and symptoms of COVID-19 infection are non-specific and may include those of a common cold or influenza such as fever, dry cough, myalgia, headache and fatigue. Sore throat and nasal congestion may also be noted. Gastrointestinal and other symptoms may occur and loss of sense of taste and smell is a frequent early symptom that may distinguish COVID-19 from other respiratory infections. The virus is highly contagious and there is no cure. In order to avoid transmission, social distancing, mask wearing and reduced person-to-person interaction are key. Definitive diagnosis is based on reverse-transcription PCR of nasopharyngeal and oropharyngeal swab samples. The clinical spectrum of the disease ranges from mild to moderate or severe. In order to minimize spread of COVID-19 to both patients and healthcare workers, virtual evaluation of suspected cases is being widely implemented and has necessitated an adjustment to the new medium by all participants. The use of virtual technology for real-time telemedicine assessment for COVID-19 provisional diagnosis and categorization of severity allows patients to receive an appropriate level of care without endangering others. We created a protocol for implementing a remote visit using a computer or mobile device. This enables patient assessement without direct contact to determine the need to visit a healthcare facility or alternatively, to be managed at home. If stable, the patient can isolate and be monitored so that should their condition worsen, they can be directed to in-person care at a hospital. Vigilance in checking on the patient's condition is crucial because those who develop severe COVID-19 may not experience dyspnea and other signs of rapid deterioration until about 5-8 days after symptom onset.
Entry Collection : COVID-19
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Others
Updated time: 23 Oct 2020
Submitted by: Marlies S. Wijsenbeek
Abstract: The importance of comprehensive care in sarcoidosis is generally acknowledged [12,13]. Here, we describe the ABCDE model, that can be used to structure comprehensive sarcoidosis management in order to improve quality of life and outcomes for patients (Figure 1). This model includes the following components: the Assessment of symptoms and patient’s needs, Backing patients by providing support and education, treatment of Complaints and Comorbidities, Disease-modifying treatment, and the involvement of Extrapulmonary specialists. As disease activity, organ involvement, and patients’ preferences may vary during the disease course, regular reassessment is essential. The ABCDE model can provide guidance to clinicians during the first work-up and follow-up of patients with sarcoidosis.
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Topic review
Updated time: 14 Sep 2021
Submitted by: Cecilia Ambrosi
Definition: Acinetobacter baumannii is regarded as a life-threatening pathogen associated with community-acquired and nosocomial infections, mainly pneumonia.
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Topic review
Updated time: 28 Sep 2021
Submitted by: Alberto Cordero
Definition: Coronary artery disease is one of the leading causes of morbidity and mortality, and its prevalence increases with age. The growing number of older patients and their differential characteristics make its management a challenge in clinical practice.
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Topic review
Updated time: 19 Nov 2020
Submitted by: Cai-Mei Zheng
Definition: The coronavirus 2019 (COVID-19) pandemic has caused a huge impact on health and economic issues. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes cellular damage by entry mediated by the angiotensin-converting enzyme 2 of the host cells and its conjugation with spike proteins of SARS-CoV-2. Beyond airway infection and acute respiratory distress syndrome, acute kidney injury is common in SARS-CoV-2-associated infection, and acute kidney injury (AKI) is predictive to multiorgan dysfunction in SARS-CoV-2 infection. Beyond the cytokine storm and hemodynamic instability, SARS-CoV-2 might directly induce kidney injury and cause histopathologic characteristics, including acute tubular necrosis, podocytopathy and microangiopathy. The expression of apparatus mediating SARS-CoV-2 entry, including angiotensin-converting enzyme 2, transmembrane protease serine 2 (TMPRSS2) and a disintegrin and metalloprotease 17 (ADAM17), within the renal tubular cells is highly associated with acute kidney injury mediated by SARS-CoV-2. Both entry from the luminal and basolateral sides of the renal tubular cells are the possible routes for COVID-19, and the microthrombi associated with severe sepsis and the dysregulated renin–angiotensin–aldosterone system worsen further renal injury in SARS-CoV-2-associated AKI. In the podocytes of the glomerulus, injured podocyte expressed CD147, which mediated the entry of SARS-CoV-2 and worsen further foot process effacement, which would worsen proteinuria, and the chronic hazard induced by SARS-CoV-2-mediated kidney injury is still unknown. Therefore, the aim of the review is to summarize current evidence on SARS-CoV-2-associated AKI and the possible pathogenesis directly by SARS-CoV-2.
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Topic review
Updated time: 28 Sep 2020
Submitted by: Darina Ocadlikova
Definition: The present investigation expands the knowledge on the immunogenic and tolerogenic potential of the chemotherapy drugs commonly used in the therapy of AML such as Daunorubicin, Cytarabine, Fludrabine and Etoposide . Among these, important differences have been observed, indicating that, particularly in an era when immunotherapy is being included in the clinical stage of AML treatment, the immunological perspective of chemotherapy should be taken into consideration in therapy decision-making.
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Topic review
Updated time: 30 Nov 2020
Submitted by: Alice Vassiliou
Definition: The pulmonary endothelium is a metabolically active continuous monolayer of squamous endothelial cells that internally lines blood vessels and mediates key processes involved in lung homoeostasis. Many of these processes are disrupted in acute respiratory distress syndrome (ARDS), which is marked among others by diffuse endothelial injury, intense activation of the coagulation system and increased capillary permeability. Most commonly occurring in the setting of sepsis, ARDS is a devastating illness, associated with increased morbidity and mortality and no effective pharmacological treatment. Endothelial cell damage has an important role in the pathogenesis of ARDS and several biomarkers of endothelial damage have been tested in determining prognosis. By further understanding the endothelial pathobiology, development of endothelial-specific therapeutics might arise. In this review, we will discuss the underlying pathology of endothelial dysfunction leading to ARDS and emerging therapies. Furthermore, we will present a brief overview demonstrating that endotheliopathy is an important feature of hospitalised patients with coronavirus disease-19 (COVID-19).
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Topic review
Updated time: 22 Sep 2021
Submitted by: Jag Bhawan
Definition: Interface dermatitis is a pathological pattern characterized by the presence of basal cell vacuolization and apoptotic keratinocytes. A variety of dermatoses exhibit interface dermatitis on pathology including the lichenoid dermatoses, graft versus host disease, connective tissue diseases, and drug reactions, among others. Several entities of interface dermatitides are known to have distinct rare adnexotropic variants whereby the inflammation involves the adnexa of the skin such as the hair follicle or the sweat gland. In lichen planus for example, follicular and syringotropic variants have been classically described. Adnexal involvement can also at times be seen on histopathology of the interface dermatitides that do not have distinct adnexotropic variants. For example, adnexal inflammation can be seen in lichen striatus or in pityriasis lichenoides.
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Topic review
Updated time: 09 Oct 2020
Submitted by: Fatima De Palma
Definition: The response to neoadjuvant chemoradiation (nCRT) is a critical step in the management of locally advanced rectal cancer (LARC) patients. Only a minority of LARC patients responds completely to neoadjuvant treatments, thus avoiding invasive radical surgical resection. Moreover, toxic side effects can adversely affect patients’ survival. The difficulty in separating in advances responder from non-responder patients affected by LARC highlights the need for valid biomarkers that guide clinical decision-making. In this context, circulating tumor biomarkers (i.e., microRNAs, circulating tumor cells and cell-free nucleic acids), as well as single nucleotide polymorphisms (SNPs) associated with miRNAs (miR-SNPs)) seem to be promising candidates for predicting LARC prognosis and/or therapy response.
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