International journal of clinical practice
-
Int. J. Clin. Pract. · Nov 2021
Meta AnalysisThe effects of Cynara scolymus L. supplementation on liver enzymes: A systematic review and meta-analysis.
A systematic review and meta-analysis was conducted to summarise studies conducted on the effects of artichoke supplementation on liver enzymes. ⋯ Artichoke supplementation elicited significant reductions in liver enzymes, especially among patients with non-alcoholic fatty liver disease.
-
Int. J. Clin. Pract. · Nov 2021
Meta AnalysisSleep-disordered breathing and risk of the breast cancer: a meta-analysis of cohort studies.
Sleep-disordered breathing (SDB) has been related to a higher risk of breast cancer whereas the results of previous studies are inconsistent. We, therefore, performed a meta-analysis to evaluate the association between SDB and subsequent risk of breast cancer in women. ⋯ SDB may be an independent risk factor for breast cancer in women, particularly in elderly females.
-
Int. J. Clin. Pract. · Nov 2021
ReviewChallenging patient phenotypes in the management of anemia of chronic kidney disease.
Chronic kidney disease (CKD) is often complicated by anaemia, which is associated with disease progression and increased hospital visits, decreased quality of life, and increased mortality. ⋯ Several therapies provide promising opportunities to address gaps with a standard of care, including hypoxia-inducible factor prolyl hydroxylase inhibitors, which stimulate haematopoiesis through promoting modest increases in serum erythropoietin and improved iron homeostasis. The critical issues in the management of anaemia of CKD in these challenging phenotypes and the clinical utility of new therapeutic agents in development for the treatment of anaemia of CKD should be assessed and the information should be made available to healthcare providers.
-
Int. J. Clin. Pract. · Nov 2021
ReviewParadigm shift in the management of metastatic Non-small Cell Lung Cancer.
Lung cancer is one of the leading causes of cancer mortality in the United States. The use of precision medicine in the past 10 years has significantly changed the therapeutic landscape of lung cancer. Management of advanced nonsmall cell lung cancer (NSCLC) has transitioned from a chemotherapeutic approach to targeted treatments and immunotherapeutic agents. Several tyrosine kinase inhibitors (TKIs) have been approved for patients with targeted mutations and patients who do not have driver mutations; immunotherapy has been recently approved as frontline therapy, which has resulted in marked improvement in overall survival and added a new tool in our armamentarium. ⋯ The use of next-generation sequencing has significantly changed our understanding of molecular oncogenic mechanisms of lung cancer. These advancements have created a paradigm shift in the treatment strategies of metastatic lung cancer from primarily chemotherapeutic approach to increasing use of targeted therapies and immune checkpoint inhibitors (ICI) leading to better survival rates and lesser toxicity.
-
Int. J. Clin. Pract. · Nov 2021
ReviewThe Role of Endotheliitis in COVID-19: Real-world Experience of 11,190 Patients and Literature Review for a Pathophysiological Map to Clinical Categorization.
COVID-19 may yield a variety of clinical pictures, differing from pneumonitis to Acute Respiratory Distress Syndrome along with vascular damage in the lung tissue, named endotheliitis. To date, no specific treatment strategy was approved for the prevention or treatment of COVID-19 in terms of endotheliitis-related comorbidities. Here, we presented our treatment strategies for 11 190 COVID-19 patients depending on categorisation by the severity of both the respiratory and vascular distress and presented the manifestations of endotheliitis in skin, lung and brain tissues according to the different phases of COVID-19. ⋯ Distinctive manifestations in each COVID-19 patient, including non-respiratory conditions in the acute phase and the emerging risk of long-lasting complications, suggest that COVID-19 has endotheliitis-centred thrombo-inflammatory pathophysiology. Daily evaluation of clinical, laboratory and radiological findings of patients and deciding appropriate pathophysiological treatment would help to reduce the mortality rate of COVID-19.