Chronic hepatitis B is mainly responsible for the morbidity and mortality from hepatitis B virus (HBV)‐related complications, including hepatocellular carcinoma (HCC) and decompensated cirrhosis. Hepatocellular carcinoma remains the main challenge in the management of not only undiagnosed and/or untreated but also diagnosed and treated patients with chronic HBV infection, as its incidence decreases but is not eliminated even after many years of effective anti‐HBV therapy. The exact mechanisms used by HBV to cause malignant transformation remain uncertain, although much of the available data are in favour of a pathogenetic role of HBx protein. Senescence is a cellular state, in which cells lose their ability to proliferate. This biological mechanism may function in a dual mode, namely being both cancer‐protective as a result of reduced cellular proliferation, but also cancer‐enhancing as a result of modulation of the tissular microenvironment by immune cells during persistent accumulation of senescent cells. Protein X of HBV protein exhibits many similarities in terms of the implemented mechanisms of action and pathways related to the biological process of cellular senescence. Concurrently, insufficient clearance of both senescent and precancerous hepatocytes combined with inadequate immune surveillance as a result of immunosenescence caused by chronic HBV infection may lead to hepatocarcinogenesis. Thus, the effect of HBV seems to be critical as a connecting link between cellular senescence and development of HCC. An ongoing research is underway towards identifying and validating markers of hepatocyte senescence, which could improve the landscape for evaluation of chronic liver disease, thereby providing valuable information in terms of HBV‐related carcinogenesis.
Major urologic oncology procedures such as radical cystectomy (RC), radical prostatectomy (RP), radical nephroureterectomy (RNU) and radical or partial nephrectomy are the gold standard operations for the treatment of urological malignancies not suitable to be dealt with using minimal invasive procedures such as transurethral resection or other conservative approaches. However, these surgical procedures carry significant risk of complications, especially in elderly and frail patients. The purpose of this review is to highlight the use of a wide variety of preoperative frailty and health status indexes and calculators. Recent data from large population based studies confirm that these calculators can assist physicians and urologists to predict the postoperative morbidity of patients undergoing major operations. Moreover, these frailty calculators can help urologists choose the most suitable and safe treatment for every individual patient. However, the absence of widely accepted specific urologic oncology calculators to predict the association between frailty and postoperative complications emphasizes the necessity for the use of a combination of calculators.
Frailty syndrome is an age-related clinical condition in which someone is prone to negative health associated outcomes such as reduction in physical activity, disability and hospitalizations 1. In particular, frail individuals are vulnerable to all these outcomes when exposed to stressors, both endogenous and exogenous 1. These stressors may have different consequences concerning people with frailty to achieve complete recovery of their former health status 1. Nowadays, health care professionals have to deal with increasingly older patients and their decline in functioning among multiple systems of their body 2. Therefore, over the past 20 years, assessment tools and indexes have been developed in order to identify people who are at great risk for adverse health associated outcomes related to frailty 3,4. Moreover, these tools and indexes may allow us to detect frail individuals perioperatively and determine our treatment strategy for frail surgical patients in order to reduce postoperative complications 4,5. Urinary tract infections (UTIs) are infectious diseases which are very common in humans and are caused by bacteria entering urethra, developing in the bladder and spreading to kidneys. They can be located in any part of the urinary tract 6. Apart from uncomplicated UTIs which can resolve either spontaneously or with antibiotics, there are also more complicated forms such us catheter-associated UTI (CaUTI), recurrent UTI (rUTI), male UTIs 7. The accurate diagnosis of these infections and early treatment play a pivotal role due to risk of recurrence, septicaemia and long-term consequences 8. UTIs are a considerable cause of morbidity among elders 9. However, the global antibiotic use for UTIs and their recurrence has led to increased antibiotic resistance making their treatment particularly challenging 10 .
is of great importance to investigate the possible correlation between these two conditions.This paper reviews the interplay between frailty syndrome and vitamin B12 levels. B12 vitamin profileVitamin B12 as a member of the corrinoids, a group of molecules with a corrin ring structure and central cobalt atom. It is found in many forms such as hydroxocobalamin, methylcobalamin, and 50-deoxyadenosylcobalamin, which
Dulaglutide is an injectable glucagon-like peptide-1 receptor agonist approved for the treatment of adults with type 2 diabetes. Angioedema is defined as self-limiting edema, localized in the deeper layers of the skin and mucosa. Angioedema can be hereditary or acquired which can be allergic due to reactions to foods, insect bites and stings, and latex, drug-induced, caused by physical stimuli and associated with lupus erythematosus and hypereosinophilia. Angioedema represents a rare adverse event of glucagon-like peptide-1 receptor agonists. The only glucagon-like peptide-1 receptor agonist that has been mentioned to induce angioedema in literature is exenatide. We report the first case of dulaglutide-associated angioedema in a 72-year-old male in order to point out to the clinicians this potential rare side effect of this drug and its clinical significance.
Background: Both SARS-CoV-2 infection and/or vaccination result in the production of SARS-CoV-2 antibodies. We aimed to compare the antibody titers against SARS-CoV-2 in different scenarios for antibody production. Methods: A surveillance program was conducted in the municipality of Deskati in January 2022. Antibody titers were obtained from 145 participants while parallel recording their infection and/or vaccination history. The SARS-CoV-2 IgG II Quant method (Architect, Abbott, IL, USA) was used for antibody testing. Results: Advanced age (>56 years old) was associated with higher antibody titers. No significant differences were detected in antibody titers among genders, BMI, smoking status, comorbidities, vaccine brands, and months after the last dose. Hospitalization length and re-infection were predictors of antibody titers. The individuals who were fully or partially vaccinated and were also double infected had the highest antibody levels (25,017 ± 1500 AU/mL), followed by people who were fully vaccinated (20,647 ± 500 AU/mL) or/partially (15,808 ± 1800 AU/mL) vaccinated and were infected once. People who were only vaccinated had lower levels of antibodies (9946 ± 300 AU/mL), while the lowest levels among all groups were found in individuals who had only been infected (1124 ± 200 AU/mL). Conclusions: Every hit (infection or vaccination) gives an additional boost to immunization status.
The aim of this narrative mini review was to investigate the potential association of the diabetic foot (DF) with sarcopenia and frailty. Data is still limited, but it appears that DF patients may be more prone to frailty. In addition, patients with DF and sarcopenia exhibit more frequently foot ulcers and amputations, as well as increased mortality rates post-operatively. Further studies are now needed to see how these realizations may be used in clinical practice, aiming to improve DF outcomes.
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