Disease-a-month : DM
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Disease-a-month : DM · Jan 2025
Erdheim-Chester disease: Comprehensive insights from genetic mutations to clinical manifestations and therapeutic advances.
Erdheim-Chester disease (ECD) is an extremely rare non-Langerhans cell disorder that is believed to include both inflammatory and neoplastic characteristics. It is caused due to genetic mutations in proto-oncogenes like BRAF and MEK, while immunological pathways have an essential role in the onset and progression of the disease. ⋯ Here, in this review, we comprehensively underline the current knowledge of ECD, including its epidemiology, clinical manifestations, genetics, pathophysiology, diagnostic modalities, and treatment options. By synthesizing existing literature and highlighting areas of ongoing research, this review aims to provide clinicians and researchers with a comprehensive understanding of ECD and guide future directions for improved patient care and outcomes.
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Diabetic kidney disease is a leading cause of kidney failure worldwide and is easily detectable with screening examination. Diabetes causes hyperfiltration and activation of the renin-angiotensin aldosterone system by hemodynamic changes within the nephron, which perpetuates damaging physiology. ⋯ Mainstays of treatment include angiotensin conversion or receptor blockade, mineralocorticoid receptor blockade, and tight glucose control. Newer agents favored in diabetic kidney disease are sodium glucose-cotransporters and glucagon-like peptide 1 receptor agonists, both for glycemic control and for various methods of reversing damaging physiology.
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Disease-a-month : DM · Jan 2025
ReviewTrafficking in the child and adolescent: Application of SAFETY and CARE for a global crisis of exploitation.
Human trafficking in the child and adolescent is a global public health crisis that can be divided into sex trafficking, labor trafficking and organ trafficking. This discussion considers basic terminology in this area, sociodemographic information on these victims, negative effects or repercussions from such egregious actions forced on the victims, issues of screening for healthcare providers based on specific risk factors/indicators, and information regarding screening tools as well as management principles for healthcare professionals. These trafficked persons are seen in varied practice settings such as primary care offices, emergency departments, street medicine operations, and others. ⋯ It is important that those involved in the care of trafficked victims understand the rights of these persons who are essentially hostages that need rescuing, and thus, employ a rights-based approach in dealing with these vulnerable children and youth. Culturally-sensitive concepts of prevention are considered as well to reduce this illegal, inhumane exploitation of our children and adolescents ubiquitously existing throughout the United States and the world. Indeed, there is much that clinicians and society can do to help these unfortunate minors who often feel hopeless and trapped in chaotic circumstances.