scholarly journals A Review Based Study of Diabetic Complications: Meta-Analysis in people with type 2 Diabetes Mellitus

2018 ◽  
Vol 2 (1) ◽  
pp. 01-04
Author(s):  
Nasser Daghria
Keyword(s):  
Diabetic Complications ◽  
Molecular Mechanisms ◽  
Vision Loss ◽  
Healthy Lifestyle ◽  
Meta Analysis ◽  
Treatment Options ◽  
International Diabetes Federation ◽  
Diagnostic Tools ◽  
Special Issue ◽  
End Stage

The prevalence of diabetes (DM) is constantly increasing worldwide at an alarming rate. According to the International Diabetes Federation in 2015, an estimated 415 million people globally were suffering from this condition. Complications of DM account for increased morbidity, disability, and mortality and represent a threat for the economies of all countries, especially the developing ones. The present special issue has been devoted to the recent progress in our understanding of diabetic complications, including the underlying molecular mechanisms, new diagnostic tools that facilitate early diagnosis, and novel treatment options. This special issue focuses on progress and challenges in basic and clinical research on these chronic complications of diabetes. The end-stage consequences of diabetic complications can include severe vision loss; end-stage renal disease necessitating dialysis or transplant; myocardial infarction and stroke; and amputations. Many of these life-threatening or disabling events can be preventable with proper “life-long” diabetes care and a healthy lifestyle.

Genetic and Molecular Testing in Thrombosis and Hemostasis: Informing Surveillance, Treatment, and Prognosis

2019 ◽  
Vol 45 (07) ◽  
pp. 720-729 ◽  
Author(s):  
Philip Crispin ◽  
Ray Mun Koo
Keyword(s):  
Molecular Mechanisms ◽  
Treatment Options ◽  
Personal Data ◽  
Rapid Expansion ◽  
Diagnostic Tools ◽  
Molecular Testing ◽  
Social Environments ◽  
Potential Benefits ◽  
Normal Hemostasis ◽  
Phenotypic Tests

AbstractThe understanding of molecular mechanisms brought about by the rapid expansion of gene sequencing has helped to characterize molecular interactions underpinning normal hemostasis and identify inherited and acquired risks for thrombosis and hemorrhage. The widespread availability of molecular testing may serve to replace some currently available investigations with more precise diagnostic tools and add to phenotypic tests. Molecular studies will increasingly enable prenatal diagnosis, confirm difficult diagnostic challenges, early intervention, and assist in prognostication. This approach facilitates specific individualization of treatment options, with personally targeted therapy expected to increase. There remain many challenges, however, in the clinic. Prior to any test there should be consideration of how the results may influence treatment, and also how they may affect the patient within their familial and social environments. Massive parallel sequencing has the capacity to produce results that create uncertainty that needs to be considered prior to testing. In this context, the potential benefits of adding phenotypic and genotypic personal data to large databases should be discussed with patients. There is a paradox in that personalized medicine is dependent on large datasets to interpret the significance of genetic variation. This review will provide an outline of specific current and emerging roles for molecular testing for the personalization of care in the practice of thrombosis and hemostasis and highlight principles that can be implemented as new opportunities inevitably arise with the rapid expansion of knowledge from genomics.

scholarly journals Molecular Aspects of Cancer Research Endometrium – The Prospect of Personalized Treatment

2021 ◽  
pp. 346-356
Author(s):  
Movchan Oksana
Keyword(s):  
Endometrial Cancer ◽  
Molecular Mechanisms ◽  
Selection Process ◽  
Meta Analysis ◽  
Treatment Options ◽  
Survival Rates ◽  
Molecular Processes ◽  
Pubmed Database ◽  
Wide Range ◽  
Molecular Aspects

Aims: Endometrial cancer is the most common gynaecological cancer, and there is a growing interest in identifying the molecular pathways involved and developing molecular-targeted treatment to prevent it. Present study was aimed to give an overview of the molecular processes involved in endometrial cancer development and treatment options. Methods: We conducted a comprehensive systematic literature review and meta-analysis. For that purpose, PubMed database was searched for related studies till June 2021 and a through selection process was adopted to select the eligible studies. Results: Endometrial malignancies are complicated molecularly, and their focused therapy has a wide range of outcomes, with median progressive survival rates ranging from 2.3 to 18 months. Conclusions: The effective treatment and therapy need a detailed understanding of the molecular mechanisms underlying the creation and progression of endometrial cancer, as well as the development of innovative targeted therapeutic agents.

scholarly journals Modern total ankle arthroplasty versus ankle arthrodesis: A systematic review and meta-analysis

2020 ◽  
Vol 12 (3) ◽  
Author(s):  
Cort D. Lawton ◽  
Adam Prescott ◽  
Bennet A. Butler ◽  
Jakob F. Awender ◽  
Ryan S. Selley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Options ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
P Value ◽  
Eligibility Criteria ◽  
Ankle Arthroplasty ◽  
Significant Difference ◽  
End Stage

The controversy in surgical management of end-stage tibiotalar arthritis with Total Ankle Arthroplasty (TAA) versus Ankle Arthrodesis (AA) has grown in parallel with the evolution of both procedures. No randomized controlled trials exist due to the vast differences in surgical goals, patient expectations, and complication profiles between the two procedures. This makes high quality systematic reviews necessary to compare outcomes between these two treatment options. The aim of this study was to provide a systematic review with meta-analysis of publications reporting outcomes, complications, and revision data following third-generation TAA and/or modern AA published in the past decade. Thirtyfive articles met eligibility criteria, which included 4312 TAA and 1091 AA procedures. This review reports data from a mean follow-up of 4.9 years in the TAA cohort and 4.0 years in the AA cohort. There was no significant difference in overall complication rate following TAA compared to AA (23.6% and 25.7% respectively, P-value 0.31). Similarly, there was no significant difference in revision rate following TAA compared to AA (7.2% and 6.3% respectively, P-value 0.65). Successful treatment of end-stage tibiotalar arthritis requires an understanding of a patients’ goals and expectations, coupled with appropriate patient selection for the chosen procedure. The decision to proceed with TAA or AA should be made on a case-by-case basis following an informed discussion with the patient regarding the different goals and complication profiles for each procedure.

scholarly journals Tu1215 – Comparison of Safety of Treatment Options for End-Stage Achalasia Or Sigmoid Esophagus: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 156 (6) ◽  
pp. S-989
Author(s):  
Naveen Prasad Gopalakrishnan Ravikumar ◽  
Adharsh Ravindran ◽  
Prashanthi N. Thota ◽  
Siva Raja ◽  
Madhusudhan R. Sanaka
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Options ◽  
End Stage ◽  
Sigmoid Esophagus

scholarly journals Special Issue “Diabetic Nephropathy: Diagnosis, Prevention and Treatment”

2020 ◽  
Vol 9 (3) ◽  
pp. 813 ◽  
Author(s):  
Marta Ruiz-Ortega ◽  
Raul R. Rodrigues-Diez ◽  
Carolina Lavoz ◽  
Sandra Rayego-Mateos
Keyword(s):  
Diabetic Nephropathy ◽  
Renal Damage ◽  
Molecular Mechanisms ◽  
Complex Disease ◽  
Clinical Medicine ◽  
Histopathological Changes ◽  
Special Issue ◽  
Genetic And Environmental Factors ◽  
Stage Renal Disease ◽  
End Stage

Diabetic nephropathy (DN) is the main cause of end-stage renal disease. DN is a complex disease mediated by genetic and environmental factors, and many cellular and molecular mechanisms are involved in renal damage in diabetes. There are no biomarkers that reflect the severity of the underlying renal histopathological changes and can effectively predict the progression of renal damage and stratify the risk of DN among individuals with diabetes mellitus. Current therapeutic strategies are based on the strict control of glucose and blood pressure levels and, although there are new anti-diabetic drugs, these treatments only retard renal damage progression, being necessary novel therapies. In this Special Issue, there are several comprehensive reviews and interesting original papers covering all these topics, which would be of interest to the growing number of readers of the Journal of Clinical Medicine.

scholarly journals Contemporary views of the mechanisms for development of myofascial pain syndrome and its treatment strategies

2020 ◽  
Vol 12 (6) ◽  
pp. 83-89
Author(s):  
G. R. Tabeeva ◽  
E. A. Kiryanova
Keyword(s):  
Molecular Mechanisms ◽  
Myofascial Pain ◽  
Trigger Point ◽  
Meta Analysis ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Diagnostic Value ◽  
Pathological Process

Myofascial pain syndrome (MFPS) is a regional pain syndrome that can be diagnosed in any age group and is characterized by the presence of a trigger point in the muscle involved in the pathological process. Clarifying the molecular mechanisms of trigger point formation and dysregulation of specific skeletal muscle proteins is important to understand the causes of abnormal sarcomere contraction observed in myofascial pain. Wide variability in using the diagnostic criteria in some cases leads to the impossibility of performing a meta-analysis of the data; in this connection, the search for the gold standard for MFPS diagnosis is actively underway. At the moment, a special clinical examination is of paramount diagnostic value. The paper considers various treatment options for myofascial pain and discusses the priority importance of using nonsteroidal anti-inflammatory drugs and muscle relaxants, as well as non-drug therapies.

scholarly journals Viral Myocarditis—From Pathophysiology to Treatment

2021 ◽  
Vol 10 (22) ◽  
pp. 5240
Author(s):  
Heinz-Peter Schultheiss ◽  
Christian Baumeier ◽  
Ganna Aleshcheva ◽  
C.-Thomas Bock ◽  
Felicitas Escher
Keyword(s):  
Molecular Mechanisms ◽  
Viral Infections ◽  
Treatment Options ◽  
Viral Myocarditis ◽  
Severe Heart Failure ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Public Health Issue ◽  
Chronic Myocarditis ◽  
Significant Public Health

The diagnosis of acute and chronic myocarditis remains a challenge for clinicians. Characterization of this disease has been hampered by its diverse etiologies and heterogeneous clinical presentations. Most cases of myocarditis are caused by infectious agents. Despite successful research in the last few years, the pathophysiology of viral myocarditis and its sequelae leading to severe heart failure with a poor prognosis is not fully understood and represents a significant public health issue globally. Most likely, at a certain point, besides viral persistence, several etiological types merge into a common pathogenic autoimmune process leading to chronic inflammation and tissue remodeling, ultimately resulting in the clinical phenotype of dilated cardiomyopathy. Understanding the underlying molecular mechanisms is necessary to assess the prognosis of patients and is fundamental to appropriate specific and personalized therapeutic strategies. To reach this clinical prerequisite, there is the need for advanced diagnostic tools, including an endomyocardial biopsy and guidelines to optimize the management of this disease. The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has currently led to the worst pandemic in a century and has awakened a special sensitivity throughout the world to viral infections. This work aims to summarize the pathophysiology of viral myocarditis, advanced diagnostic methods and the current state of treatment options.

Position Paper on Treatment of Hepatitis C in Romania, 2017. Part One

2017 ◽  
Vol 26 (2) ◽  
pp. 171-181 ◽  
Author(s):  
Liana Gheorghe ◽  
Ioan Sporea ◽  
Speranţa Iacob ◽  
Roxana Şirli ◽  
Anca Trifan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Limit Of Detection ◽  
Position Paper ◽  
Hcv Infection ◽  
Fixed Dose ◽  
Diagnostic Tools ◽  
End Stage Liver Disease ◽  
End Stage

Background & Aims: Hepatitis C Virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments became available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country.Methodology: A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention has been created. These items were discussed and rated. Decisions were taken by consensus.Recommendations: We present here the first of the two parts of our Society’s recommendations for chronic HCV infection treatment. An agreement was reached regarding the diagnostic tools, the assessment of severity and the up-dated therapy schedules.Conclusions: This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to the real-life conditions in this country.Abbreviations: DAAs: Direct-acting antivirals; DDIs: Drug-drug interactions; ESLD: End-stage liver disease; ESRD: End-stage renal disease; eGFR: Estimated glomerular filtration rate; EASL: European Association for the Study of the Liver; EMA: European Medicines Agency; FDA: US Food and Drug Administration; FDC: Fixed-dose combination; GT: Genotype; GRADE: Grading of Recommendations Assessment, Development and Evaluation; HCV: Hepatitis C virus; HCC: Hepatocellular carcinoma; LT: Liver transplantation; LLD: Lower limit of detection; MELD score: Mayo-Clinic End-Stage Liver Disease score; ANMDM: National Agency of Medicines and Medical Devices; PPIs: Proton pump inhibitors; PWID: People who inject drugs; RCT: Randomized controlled trial; RDT: Rapid diagnostic test; RAS: Resistance-associated substitution; SRGH: Romanian Society of Gastroenterology and Hepatology; SAE: serious adverse events; SPC: Summary of Product Characteristics; SVR: Sustained virologic response.

The ENIGMA Brain Injury Working Group: Approach, Challenges, and Potential Benefits

2019 ◽  
Author(s):  
Elisabeth A. Wilde ◽  
Emily L. Dennis ◽  
David F Tate
Keyword(s):  
Brain Injury ◽  
Working Group ◽  
Meta Analysis ◽  
Special Issue ◽  
Group Approach ◽  
Challenges And Opportunities ◽  
Brain Structure And Function ◽  
Potential Benefits ◽  
And Function ◽  
Neuroimaging Genetics

The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium brings together researchers from around the world to try to identify the genetic underpinnings of brain structure and function, along with robust, generalizable effects of neurological and psychiatric disorders. The recently-formed ENIGMA Brain Injury working group includes 8 subgroups, based largely on injury mechanism and patient population. This introduction to the special issue summarizes the history, organization, and objectives of ENIGMA Brain Injury, and includes a discussion of strategies, challenges, opportunities and goals common across 6 of the subgroups under the umbrella of ENIGMA Brain Injury. The following articles in this special issue, including 6 articles from different subgroups, will detail the challenges and opportunities specific to each subgroup.

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