The use of adenosine and adenosine triphosphate testing in the diagnosis, risk stratification and management of patients with syncope: Current evidence and future perspectives

Among patients suffering from coronavirus disease 2019 (COVID-19) syndrome, one of the worst possible scenarios is represented by the critical lung damage caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-induced cytokine storm, responsible for a potentially very dangerous hyperinflammatory condition. Within such a context, interleukin-6 (IL-6) plays a key pathogenic role, thus being a suitable therapeutic target. Indeed, the IL-6-receptor antagonist tocilizumab, already approved for treatment of refractory rheumatoid arthritis, is often used to treat patients with severe COVID-19 symptoms and lung involvement. Therefore, the aim of this review article is to focus on the rationale of tocilizumab utilization in the SARS-CoV-2-triggered cytokine storm, as well as to discuss current evidence and future perspectives, especially with regard to ongoing trials referring to the evaluation of tocilizumab’s therapeutic effects in patients with life-threatening SARS-CoV-2 infection.

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Perioperative Systemic Treatment for Muscle-Invasive Bladder Cancer: Current Evidence and Future Perspectives

International Journal of Molecular Sciences ◽

10.3390/ijms22137201 ◽

2021 ◽

Vol 22 (13) ◽

pp. 7201

Author(s):

In-Ho Kim ◽

Hyo-Jin Lee

Keyword(s):

Bladder Cancer ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Systemic Treatment ◽

Checkpoint Inhibitors ◽

Invasive Bladder Cancer ◽

Current Evidence ◽

Future Perspectives ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive

Radical cystectomy is the primary treatment for muscle-invasive bladder cancer; however, approximately 50% of patients develop metastatic disease within 2 years of diagnosis, which results in dismal prognosis. Therefore, systemic treatment is important to improve the prognosis of muscle-invasive bladder cancer. Currently, several guidelines recommend cisplatin-based neoadjuvant chemotherapy before radical cystectomy, and adjuvant chemotherapy is recommended in patients who have not received neoadjuvant chemotherapy. Immune checkpoint inhibitors have recently become the standard treatment option for metastatic urothelial carcinoma. Owing to their clinical benefits, several immune checkpoint inhibitors, with or without other agents (including other immunotherapy, cytotoxic chemotherapy, and emerging agents such as antibody drug conjugates), are being extensively investigated in perioperative settings. Several studies for perioperative immunotherapy have shown that immune checkpoint inhibitors have promising efficacy with relatively low toxicity, and have explored the predictive molecular biomarkers. Herein, we review the current evidence and discuss the future perspectives of perioperative systemic treatment for muscle-invasive bladder cancer.

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Risk stratification in cardiogenic shock: a focus on the available evidence

Heart Failure Reviews ◽

10.1007/s10741-021-10140-7 ◽

2021 ◽

Author(s):

C. Sciaccaluga ◽

G. E. Mandoli ◽

N. Ghionzoli ◽

F. Anselmi ◽

C. Sorini Dini ◽

...

Keyword(s):

Risk Stratification ◽

Cardiogenic Shock ◽

Clinical Syndrome ◽

Diagnostic Assessment ◽

Prognostic Scores ◽

Current Evidence ◽

Efficient Resource ◽

Threatening Condition ◽

Life Threatening ◽

Future Direction

AbstractCardiogenic shock is a clinical syndrome which is defined as the presence of primary cardiac disorder that results in hypotension together with signs of organ hypoperfusion in the state of normovolaemia or hypervolaemia. It represents a complex life-threatening condition, characterized by a high mortality rate, that requires urgent diagnostic assessment as well as treatment; therefore, it is of paramount important to advocate for a thorough risk stratification. In fact, the early identification of patients that could benefit the most from more aggressive and invasive approaches could facilitate a more efficient resource allocation. This review attempts to critically analyse the current evidence on prognosis in cardiogenic shock, focusing in particular on clinical, laboratoristic and echocardiographic prognostic parameters. Furthermore, it focuses also on the available prognostic scores, highlighting the strengths and the possible pitfalls. Finally, it provides insights into future direction that could be followed in order to ameliorate risk stratification in this delicate subset of patients.

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Oral field cancerization: current evidence and future perspectives

Oral and Maxillofacial Surgery ◽

10.1007/s10006-012-0317-x ◽

2012 ◽

Vol 16 (2) ◽

pp. 171-180 ◽

Cited By ~ 53

Author(s):

Punnya V. Angadi ◽

J. K. Savitha ◽

Sanjay S. Rao ◽

Y. Sivaranjini

Keyword(s):

Field Cancerization ◽

Current Evidence ◽

Future Perspectives

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Dysglycemia in the critically ill patient: current evidence and future perspectives

Revista Brasileira de Terapia Intensiva ◽

10.5935/0103-507x.20170054 ◽

2017 ◽

Vol 29 (3) ◽

Cited By ~ 7

Author(s):

Ignacio Aramendi ◽

Gastón Burghi ◽

William Manzanares

Keyword(s):

Critically Ill ◽

Current Evidence ◽

Critically Ill Patient ◽

Future Perspectives

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Unpuzzling COVID-19: tissue-related signaling pathways associated with SARS-CoV-2 infection and transmission

Clinical Science ◽

10.1042/cs20200904 ◽

2020 ◽

Vol 134 (16) ◽

pp. 2137-2160 ◽

Cited By ~ 3

Author(s):

Daniella S. Battagello ◽

Guilherme Dragunas ◽

Marianne O. Klein ◽

Ana L.P. Ayub ◽

Fernando J. Velloso ◽

...

Keyword(s):

Signaling Pathways ◽

Clinical Impact ◽

World Health ◽

Current Evidence ◽

Cellular Interaction ◽

Crucial Importance ◽

Future Perspectives ◽

Organ Systems ◽

Health Organization ◽

The City

Abstract The highly infective coronavirus disease 19 (COVID-19) is caused by a novel strain of coronaviruses – the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – discovered in December 2019 in the city of Wuhan (Hubei Province, China). Remarkably, COVID-19 has rapidly spread across all continents and turned into a public health emergency, which was ultimately declared as a pandemic by the World Health Organization (WHO) in early 2020. SARS-CoV-2 presents similar aspects to other members of the coronavirus family, mainly regarding its genome, protein structure and intracellular mechanisms, that may translate into mild (or even asymptomatic) to severe infectious conditions. Although the mechanistic features underlying the COVID-19 progression have not been fully clarified, current evidence have suggested that SARS-CoV-2 may primarily behave as other β-coronavirus members. To better understand the development and transmission of COVID-19, unveiling the signaling pathways that may be impacted by SARS-CoV-2 infection, at the molecular and cellular levels, is of crucial importance. In this review, we present the main aspects related to the origin, classification, etiology and clinical impact of SARS-CoV-2. Specifically, here we describe the potential mechanisms of cellular interaction and signaling pathways, elicited by functional receptors, in major targeted tissues/organs from the respiratory, gastrointestinal (GI), cardiovascular, renal, and nervous systems. Furthermore, the potential involvement of these signaling pathways in evoking the onset and progression of COVID-19 symptoms in these organ systems are presently discussed. A brief description of future perspectives related to potential COVID-19 treatments is also highlighted.

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Role of endoscopic ultrasound in anticancer therapy: Current evidence and future perspectives

World Journal of Gastrointestinal Oncology ◽

10.4251/wjgo.v13.i12.1863 ◽

2021 ◽

Vol 13 (12) ◽

pp. 1863-1879

Author(s):

Andre Bratanic ◽

Dorotea Bozic ◽

Antonio Mestrovic ◽

Dinko Martinovic ◽

Marko Kumric ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Anticancer Therapy ◽

Current Evidence ◽

Future Perspectives

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Validation of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle invasive bladder cancer (NMIBC): a cohort analysis with systematic review.

10.21203/rs.2.13701/v1 ◽

2019 ◽

Author(s):

Mateusz Jobczyk ◽

Konrad Stawiski ◽

Wojciech Fendler ◽

Waldemar Różański

Keyword(s):

Bladder Cancer ◽

Risk Stratification ◽

Cohort Analysis ◽

Risk Groups ◽

Invasive Bladder Cancer ◽

Sufficient Evidence ◽

Current Evidence ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive ◽

Better Than

Abstract Purpose: To validate and summarize current evidence about the reliability of EORTC, CUETO and EAU risk stratification in prediction of recurrence, progression and death of patients with initially non-muscle-invasive bladder cancer (NMIBC).Methods: Retrospective cohort analysis of 322 patients with newly diagnosed NMIBC. We assessed the concordance (Harrell's c-index) of our results with calculated risk scores in Cox proportional hazard regression models and utilized receiver operating characteristic curve analysis (area under curve; AUCROC). Lastly, to further confirm our observations we conducted a systematic reviewResults: 1-year and 5-year c-indices ranged from 0.55 to 0.66 for recurrence and from 0.72 to 0.82 for progression. AUCROC of predictions ranged from 0.46 for 1-year recurrence risk based on CUETO groups to 0.82 for 1-year progression risk based on EAU risk groups. The accuracy of prediction was lower for patients treated with BCG maintenance immunotherapy. EORTC model (overall c-index c=0.64; 95%CI:0.61-0.68) was superior to EAU (p=0.035; 0.62; 95%CI: 0.59-0.66) and CUETO (p<0.001; c=0.53; 95%CI:0.50-0.56) model in recurrence prediction. EORTC model (c=0.82; 95%CI:0.77-0.86) also performed better than CUETO (p=0.008; c=0.73; 95%CI:0.66-0.81) but there was no sufficient evidence that it performed better than EAU (p=0.572; c=0.81; 95%CI:0.77-0.84) for predicting progression. EORTC and CUETO comparably predicted progression in BCG-treated EAU high-risk patients (p=0.48).Conclusions: The division into risk groups by EORTC, CUETO and EAU offered moderately accurate predictions about recurrence and progression of NMIBC, which emphasizes the urgent need for the development of more personalized and accurate predictive tool. EORTC provided the best recurrence and progression prediction.

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