Medical principles and practice : international journal of the Kuwait University, Health Science Centre
-
In 1 year, COVID-19 spread rapidly worldwide affecting all societies and most age-groups. It has taken not only a toll of human lives (approaching 220 million people infected with 4.55 million reported deaths at time of writing) but also decimated every economy as countries struggle to control infection rates by introducing draconian lockdown and social distancing measures, bringing great suffering well beyond medical effects of the disease. A parallel pandemic has resulted in a deluge of information emanating from both scientific as well as international news media including social media platforms. ⋯ This review highlights some of the issues concerning the handling of the COVID-19 crisis by governments worldwide, the medical and scientific communities, and the media and how this may have laid the foundations for a far greater medical, social, and economic burden in the coming years. We present comparative data to challenge current conceptions of this disease in the more general context of human health to provide a perspective that seems to have been lost in the general panic. We need more rational approaches to the handling of a disease which is unlikely to disappear from our spectrum of afflictions even after the magnifying glass has been removed.
-
In mammalian cells, DNA damage response initiates repair by error-free homologous recombination (HRR) or by error-prone non-homologous end joining (NHEJ). DNA damage is detected by PARP proteins that facilitate this repair, both in normal cells and in cancer cells. Cells containing BRCA1/2 mutations have an HRR-deficient repair mechanism which may result in unrepaired one-ended double-strand breaks and stalled replication forks, considered as the most lethal cell damage. ⋯ However, there is need for multicenter trials, preferably conducted without commercial guidance and funding. Some of the available trials reported resistance to PARP inhibitors. In this review, we also describe the various causes of resistance to PARP inhibitors and research indicating how resistance can be overcome.
-
Regulatory T (Treg) cells play an important role in implantation of the embryo and maintenance of pregnancy after allogeneic mating. Implantation failure, miscarriage, and preeclampsia are associated with decreased numbers of Treg cells or with dysfunctional Treg cells. Treg cells are classified into naturally occurring Treg (nTreg) cells or thymus-derived Treg (tTreg) cells that differentiate in the thymus and induce tolerance to self-antigens, while induced Treg (iTreg) or peripheral Treg (pTreg) cells differentiate in the periphery and induce transient tolerance to foreign antigens. ⋯ In addition to the volume of paternal/fetal antigen-specific CD8+ T cells, the number of paternal/fetal antigen-specific Treg cells, which protect the fetus/placenta against maternal immune cell attack, increases after the second trimester of pregnancy. Clonal Treg cells which are surrogate markers of paternal/fetal antigen-specific Treg cells in humans may be involved in the development of preeclampsia during the mid- to late pregnancy stage, as evidenced by their downregulation in the decidua of preeclamptic cases. This review summarizes recent findings on Treg cells and discusses the roles, in the maintenance of pregnancy, of different types of Treg cells such as paternal/fetal antigen-specific Treg, pregnancy-associated memory Treg, nTreg (or tTreg), and iTreg (or pTreg cells).
-
The purpose of this study was to analyse the prevalence of tonsilloliths and to determine radiographically whether there is a relationship between tonsilloliths and dental plaque-related pathologies in a series of digital panoramic radiographs. ⋯ The relationship between dental plaque-related pathologies and tonsilloliths observed in this retrospective study should be confirmed by computed tomography studies and randomized, prospective, clinical trials conducted in a multidisciplinary manner.
-
Acute myeloid leukemia (AML) is a hematological malignancy that arises from the clonal proliferation of immature myeloid cells. Although the number of AML cases has dramatically increased worldwide, information on its prevalence and incidence in Kuwait is lacking. This study reports the incidence of AML and patient demographics in the country from 2014 to 2020, based on the 2016 WHO classification of AML. ⋯ Our study may help predict the future trends of AML in Kuwait to help improve clinical management and patient outcomes.