The Serine/Threonine Protein Kinase (Akt)/ Protein Kinase B (PkB) Signaling Pathway in Breast Cancer

According to statistical data published in 2019, breast cancer is among the leading causes of death in women worldwide. The serine/threonine kinase (AKT) or protein kinase B (PkB) signaling pathway is activated by phosphorylation processes, which further is associated with cell growth, proliferation, and survival, but also with activation of glucose metabolism. Mutations of the AKT signaling pathway components (especially PI3KCA and PTEN) have been observed in breast cancer patients, which are associated with resistance to hormonal treatment. Many clinical trials are testing the effect of AKT inhibition in order to block the growth and proliferation of breast cancer cells. The purpose of this review is to present the incidence of this neoplastic disease, to describe AKT signaling pathways activation, mutations that occur at its level, and inhibitors that can block this protein kinase

A brief review of the literature on the malignant ureteral obstruction

Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be aborted individually. Lack of specific treatment, either palliative or definitive, can severely damage renal function and lifetime expectancy in patients, causing even more damage that could otherwise be avoided. Prompt management directed at the recovery of renal function is the main goal in such cases. Even after urinary flow is restored, life threatening post-obstructive diuresis needs to be managed

The Serine/Threonine Protein Kinase (Akt)/ Protein Kinase B (PkB) Signaling Pathway in Breast Cancer

According to statistical data published in 2019, breast cancer is among the leading causes of death in women worldwide. The serine/threonine kinase (AKT) or protein kinase B (PkB) signaling pathway is activated by phosphorylation processes, which further is associated with cell growth, proliferation, and survival, but also with activation of glucose metabolism. Mutations of the AKT signaling pathway components (especially PI3KCA and PTEN) have been observed in breast cancer patients, which are associated with resistance to hormonal treatment. Many clinical trials are testing the effect of AKT inhibition in order to block the growth and proliferation of breast cancer cells. The purpose of this review is to present the incidence of this neoplastic disease, to describe AKT signaling pathways activation, mutations that occur at its level, and inhibitors that can block this protein kinase

Underactive bladder - an underestimated entity

Introduction. The concept of underactive bladder is relatively new. Currently there is no generally accepted definition of this pathology. Diagnosis depends on urodynamic findings, and symptoms are usually rare and intricated with the symptoms of other urinary pathology. Matherials and methods. This review examines the current literature on underactive bladder regarding pathology, definition, diagnosis, current guidelines, and any further potential medical developments. Conclusions. Underactive bladder is a poorly understood pathologic condition. Only since 2002 has there been any consensus regarding the definition. The diagnosis relies only on urodynamics; clinical diagnosis is a challenge even for a consultant; and treatment does not seem to alleviate much of the suffering. This disease remains underrecognized and undertreated. More research is needed to identify less invasive diagnosis tools and treatment for this pathology

The importance of early arthritis in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disorder that manifests predominantly in the synovial joint, where it causes a chronic inflammatory process, leading to early osteoarticular destructions. These destructions are progressive and irreversible, generating a significant functional deficiency. During the last years, the diagnostic approach of RA has focused on early arthritis. Early arthritis can develop into established RA or another established arthropathy, like systemic lupus erythematosus or psoriatic arthritis. It can have a spontaneous resolution or may remain undifferentiated for indefinite periods of time. The management of early arthritis has changed considerably in the past few years, under the influence of new concepts of diagnosis and new effective therapies. The treatment goal of early arthritis should now be the clinical remission and prevention of joint destruction. Methotrexate is the first line of therapy, used to treat early arthralgia and to reverse or limit impending exacerbation to RA. Biological treatment is used as a second line therapy in patients with severe disease who do not respond or have a contraindication to disease-modifying antirheumatic drugs (DMARDs). Patients with early arthritis should usually be identified and directed to rheumatologists to confirm the presence of arthritis, and to establish the correct diagnosis plus to initiate the proper treatment strategies

New oral anticoagulants and their reversal agents

Atrial fibrillation is a commonly encountered pathology in medical practice, and its prevalence has shown a continuous rise over the past years. Atrial fibrillation has a significant impact on patients\u27 quality of life, not only due to the standard anticoagulant treatment with vitamin K antagonists that require close monitoring and dose adjustment, but also due to the fragile equilibrium between hemorrhagic and thrombotic risks. The introduction of new oral anticoagulants (NOACs) in the treatment guidelines for atrial fibrillation has improved the quality of life, as NOACs do not require close monitoring or dose adjustments. However, even if the safety profile of the NOACs regarding the hemorrhagic risk is superior to vitamin K antagonists, the problem raised by an unexpected hemorrhage (e.g. severe hemorrhage after an accident) and the need for efficient hemostasis in a chronic anticoagulated patient has remained unsolved. To find a solution for this problem, reversal agents for NOACs have been developed and tested, and two of them, idarucizumab and andexanet-alpha, have already been approved by the FDA, thus making NOACs increasingly appealing as a choice of anticoagulation treatment

A brief review of the literature on the malignant ureteral obstruction

Malignant ureteral obstruction (MUO) caused by a primarily urological tumor or secondary to a late-stage malignancy can be difficult for the urologist to manage. Due to a lack of clinical data on the management of MUO, every case is particular and should be aborted individually. Lack of specific treatment, either palliative or definitive, can severely damage renal function and lifetime expectancy in patients, causing even more damage that could otherwise be avoided. Prompt management directed at the recovery of renal function is the main goal in such cases. Even after urinary flow is restored, life threatening post-obstructive diuresis needs to be managed

The impact of socio-demographic factors on depression and anxiety in the context of quality of life

In the current conditions of life, the analysis of mental illness must be defined through the lens of human relationships with environmental, social, cultural, and dynamic factors that substantially impact human mental balance. The study aims to analyze the correlations between depression and anxiety and different socio-demographic factors such as age, sex, background, occupation, identification of the medical impact (number of hospitalizations and number of days of hospitalization), presence of comorbidities and different methods of therapy, from the point of view of the therapeutic response. All these bio-psycho-social indicators translate relevant aspects of the disease on the population's quality of life

Exposure to fluoride through daily oral home-care and professionally procedures in the dental office for a group of Romanian children

Objectives. The aim of this study was the assessment of the exposure to fluoride through oral homecare products as well as professional applications for a group of children from Bucharest, Romania. Materials and methods. The cross-sectional study was conducted in 2021 on a sample of 207 subjects from Bucharest, Romania, including parents with children between 1 and 12 years distributed in three age groups: 1-2 years, 3-5 years and 6-12 years. The assessment used a 10 items questionnaire, on-line and self-administered and completed by the parents most involved in child’s oral health. Results. The correct concentration of fluoride in child’s toothpaste was used as it follows 3.7% of 1-2 year-olds, 4.24% of 3-5 year-olds, 8.06% 6-12 year-olds. The age-adapted recommended quantity of toothpaste was used for 37.4% of children of 1-2 years, 61.86% of children of 3-5 years and 24.19% of children of 6-12 years. Twice-daily tooth brushing was performed by 40.74% 1-2 year-olds, 44.92% 3-5 year-olds, 62.90% 6-12 year-olds. In-office professional fluoridation was low, 88.89% of 1-2 years old children, 92.37% of 3-5 years old children and 77.42% 6-12 years old children were never exposed to such preventive procedures. Conclusions. Children from the present study had a suboptimal exposure to fluoride through oral home care products as well as to topical in-office professionally application of high concentration fluoride product

Allergy skin testing with nonirritating concentrations of anesthetic agents

Immediate hypersensitivity reactions to anesthetic agents are rare, but with a worrying morbidity and mortality rate. Allergy evaluation is mandatory when hypersensitivity reactions to anaesthetic agents are suspected. Skin prick tests and intradermal tests are important tools due to their clinical utility in establishing the diagnosis of IgE-mediated hypersensitivity and evaluation of cross-reactivity. This article presents, for informational purposes only, the nonirritating concentrations of general anesthetics and adjuvant agents, neuromuscular blocking agents and agents used in local and regional anesthesia, used in clinical practice for allergy skin testing according to international guidelines. The delayed hypersensitivity adverse reactions can be assessed by patch testing. Concentrations used for such skin testing with topical anesthetic agents from the European baseline series, international comprehensive baseline series and medicament series, are also presented