Medicina
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Background and Objectives: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, but their use is associated with a spectrum of immune-related adverse events (irAEs), including endocrine disorders. This study aims to investigate the incidence, timing, treatment modalities, and impact of ICI-related endocrine side effects in cancer patients. Materials and Methods: This retrospective study analyzed 139 cancer patients treated with ICIs between 2016 and 2022. ⋯ Early recognition, prompt diagnosis, and appropriate management are crucial to minimize their impact on patient health and quality of life. This study highlights the potential association between irAEs and improved clinical outcomes. Further research is needed to elucidate the underlying mechanisms and identify predictive biomarkers for irAE development.
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Background and Objectives: This systematic review aimed to compare the effect of chitosan in smear layer removal with other commonly used chelators during root canal treatment. Materials and Methods: The PRISMA guidelines were followed. Ex vivo studies performed in non-endodontically treated extracted human permanent teeth with a fully formed apex, in which sodium hypochlorite was the main irrigant and chitosan was used as final irrigation to observe its capacity to remove the smear layer using a Scanning Electron Microscope (SEM), were included. ⋯ Quantitative analysis of the results was not possible due to the heterogeneity found between the study methodologies of the included articles. Conclusions: Within the limitations of this study, 0.2% chitosan may be considered as a promising irrigation solution when employed as a final irrigant in order to remove the smear layer. Nonetheless, a standardized protocol for the use of chelators in root canal treatment should be established in future studies.
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Background and Objectives: The neutrophil to lymphocyte ratio (NLR) and other full blood count indices have been used as a marker of inflammation in a variety of diseases. The aim of the current review is to summarize the existing knowledge on the use of these indices in retinal diseases. Materials and Methods: A systematic review of the literature was conducted to find eligible articles. ⋯ Conclusions: The NLR and other indices can be used as diagnostic markers in retinal diseases and as prognostic factors of the response to treatment. The small sample size and short follow-up of the included studies and the variation in the measurement and cutoffs used for the NLR are limitations of its use in retinal conditions. Future studies need to further validate these findings and try to establish a link between these ratios and retinal phenotypes.
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Background and Objectives: People living with HIV/AIDS have been impacted notably by the COVID-19 pandemic in diverse dimensions. Although some impacts of COVID-19 on PLHIV have been well documented, there is still insufficient research that captures the overall understanding of the implications of COVID-19 for the healthcare utilization among PLHIV. This review aims to evaluate the impact of COVID-19 on PLHIV, narrowing it down to women living with HIV/AIDS. ⋯ Other methods of healthcare delivery such as telemedicine and postage services were instrumental to the delivery of HIV care services. Conclusions: The COVID-19 pandemic reduced the overall uptake of healthcare services among PLHIV and women living with HIV/AIDS. There is a need to boost research and strengthen health emergency preparedness for PLHIV, particularly women living with HIV/AIDS, during pandemics and further harness and maximize the use of contemporary healthcare delivery methods other than the traditional ones.
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In today's world, with its continuing advancements in genetics, the identification of Lynch syndrome (LS) increasingly relies on sophisticated genetic testing techniques. Most guidelines recommend a tailored surveillance program, as well as personalized prophylactic and therapeutic approaches, according to the type of dMMR gene mutation. Carriers of path_MLH1 and path_MSH2 genes have a higher risk of developing colorectal cancer (CRC), despite intensive colonoscopic surveillance. ⋯ However, this risk depends on the type of dMMR gene mutation. For carriers of the high-risk variants (MLH1, MSH2 and EPCAM) who have already developed colon cancer, it is strongly recommended a subtotal or total colectomy is performed, while partial colectomy followed by endoscopic surveillance is an appropriate management approach to treat colon cancer in carriers of the low-risk variants (MSH6 and PMS2). On the other hand, extended surgery for index rectal cancer (such as total proctocolectomy) is less effective than extended surgery for index colon cancer from the point of view of metachronous CRC risk reduction, and is associated with a decreased quality of life.