Triple-negative breast cancer (TNBC) is characterized by a lack of expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) and unfortunately is not associated with good prognosis. Treatment of breast cancer mainly depends on chemotherapy, due to the lack of specifically approved targeted therapies for TNBC. It is of paramount importance to find new therapeutic approaches, as resistance to chemotherapy frequently occurs. Herein, we present clinical studies published within the last five years, in order to reveal possible targeted therapies against TNBC. We aimed to discuss factors against TNBC, such as tyrosine kinase inhibitors, anti-androgens, poly ADP-ribose polymerase-1 (PARP-1) inhibitors, anti-angiogenic factors, immune checkpoints and histone deacetylase inhibitors (HDACI). Furthermore, the PI3K/AKT/mTOR pathway seems to be a promising field for the development of new anti-TNBC targeted therapies. Data from 18 clinical trials with patients suffering from TNBC were summarized and presented descriptively. Breast cancer is one of the most common cancers in females, comprising heterogeneous tumors with a variety of biological features, clinical course, prognosis and response to therapy (1, 2). In 2017, triple-negative breast cancer (TNBC) accounted for about 15% of all the new cases of breast cancer in the United States (3-7). Many different epidemiological studies have revealed that TNBC was more likely to arise among females characterized by early menarche, higher waist to hip ratio, higher parity, shorter duration of breast feeding, higher body mass index, and was more common among pre-menopausal patients (8). TNBC is a disease defined by the absence of human epidermal growth factor receptor 2 (HER2) and hormone receptors (HR), specifically the progesterone (PR) and the estrogen receptor (ER) (9) (Figure 1). There are at least 6 different subtypes, which demonstrate different biological behavior, including the basal-like 1 and 2 (BL-1 and BL-2), mesenchymal (M), mesenchymal stem-like (MSL), immunomodulatory (IM), luminal androgen receptor (LAR) and unstable subtype (7, 10).
SCI is regarded as one of the most devastating central nervous system (CNS) injuries, exhibiting an alarmingly rising incidence rate, indirectly connected with the expansion of the global economy. The consequences of SCI are multidimensional: SCI injuries may result in permanent voluntary motor dysfunction and loss of sensation while incurring heavy economic and psychological burdens as part of the treatment. Thus, it is crucial to develop effective and suitable SCI treatment strategies. Collagen-based scaffold application is one of the most promising methods of SCI treatment. This review compiles newer bibliographical data regarding the application of collagen scaffolds for the treatment of Spinal cord injury (SCI) in animal models. Recently, several relevant studies have been carried out using carefully selected animals with similar pathophysiology to humans. In mouse, rat and canine models that have undergone transection or hemisection, the stump connection, the transplanted cell differentiation, and the elimination of glial scar are promising. Also, encouraging results have been found regarding the increased neuronal growth, the decreased collagen deposition, the behavioral recovery, the improved electrophysiology, and the enhanced axonal regeneration.
Tibiofemoral dislocation after primary total knee arthroplasty (TKA) is a rare but potentially devastating complication with various patient-related and surgeon-related predisposing factors. We present the case of an obese 86-year-old woman who sustained an atraumatic posterior tibiofemoral dislocation 3 days after a primary medial-pivot design TKA. The knee remained unstable after reduction, owing to significant hamstring hypertonia. The administration of botulinum toxin injections in the hamstrings resulted in no clinical improvement. The periprosthetic infection workup was negative and the neurological impairment of the patient was excluded. The patient was reoperated with extensive hamstring release and the application of a lateral external fixator. The external fixator was removed 6 weeks postoperatively, and physical therapy was initiated. At 1-year follow-up, the patient had a painless, stable knee with a 0–100° range of motion, without any neuromuscular impairment.
Ledderhose disease is a rare benign pathology defined by the formation of nodules along the plantar fascia. The fibromas can slowly grow, resulting in pain and functional disability. Diagnosis is mainly clinical, but it is advised to confirm with an MRI or ultrasound scan. Multiple options of conservative treatment have been suggested with varying levels of evidence. Initially, the treatment aims to relieve symptoms and pain. Treatment options such as extracorporeal shockwave therapy, radiotherapy, intralesional steroid injection, Clostridium histolyticum collagenase injections, Verapamil and Tamoxifen can be used if the symptoms persist. A partial or complete fasciectomy is often performed in cases where conservative treatment fails. We present a case of bilateral plantar fibromatosis treated with extracorporeal shockwave therapy and transfer electrical capacitive and resistive therapy. The patient had an intense pain during the shockwave therapy sessions, which significantly decreased after the transfer electrical capacitive and resistive therapy protocol. At the 12-month follow-up, the patient showed significant improvement in the Visual Analog Scale from 6/10 to 1/10 on the right foot and from 8/10 to 4/10 on the left foot.
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