ABSTRACT
Triple-negative breast cancer (TNBC) has been extensively studied not just for its aggressive behavior but also to understand its complex molecular nature. This type of heterogeneous tumor shows no expression of estrogen receptor (ER) or progesterone receptor (PR) and does not express the HER2 gene, and often these tumors are high grade with distinct histological groups. The basal-like subtype is most commonly related to the TNBC type of neoplasms; it can be further classified according to Lehmann and Burstein expert's criteria. TNBC is related to breast stem cell markers such as CD44+/CD24- and high levels of enzyme aldehyde dehydrogenase (ALDH), which have been shown to possess stem cell features that are involved in differentiation, vascular invasion, tumorigenesis, and metastatic potential. CD44+/CD24- and high levels of ALDH have significance as markers as well as indicators of poor prognosis in TNBC. The databases used in this review are PMC, PubMed, and Google Scholar.
ABSTRACT
Delirium is defined by the DSM-5 as a fluctuating course of disturbance in attention, cognition, and awareness that develops over a short period without any pre-existing neurocognitive disorder. As people age, there is an increased risk of complications that may occur following a surgical procedure and one such acute complication is delirium. Studies are emerging to reduce the incidence of postoperative delirium, and one such preventive measures implemented in recent years include the administration of dexmedetomidine, a high selectivity α-2 adrenoceptor agonist. This study aims to review the efficacy of Dexmedetomidine in the prevention of postoperative delirium in randomized controlled trials in patients older than 18 years of age. The literature was explored in three online databases, namely, PubMed, Science Direct, and Scopus. Appropriate keywords and MesH terms were employed to scrutinize relevant articles that demonstrated the effects of dexmedetomidine in the prevention of postoperative delirium. The data was restricted to randomized controlled trials and clinical trials published from 2017 to 2021 in human patients older than >18 years of age undergoing non-cardiac-related procedures. The randomized clinical trials were critically assessed with the Cochrane risk of bias tool. We proceeded to screen 428 records with the assessment of the PRISMA chart and filtered out 420 papers to obtain a total of eight studies where we identified data such as sample size, types of surgeries in which the patients were involved, the delirium assessment tool, the plan of the administration of dexmedetomidine and the outcomes evaluated in each study. The Confusion Assessment Method (CAM) was the prevailing assessment tool used with the sole purpose to evaluate the incidence of postoperative delirium as the primary outcome, and assessment of inflammatory cytokines, sleep quality, and pain scales were considered as secondary outcomes. The dosage of dexmedetomidine varied among studies, and it displayed varying impacts on postoperative delirium and the secondary outcomes as well. Limitations include varying ages and ethnicities of the population. It was concluded that dexmedetomidine prevents the development of postoperative delirium in elderly patients undergoing non-cardiac surgical interventions by modulating important predisposing factors such as neuroinflammation, pain, and sleep quality. No funding was made for this study.
ABSTRACT
Sickle cell disease (SCD) affects the red blood cells, which become sickle-shaped, leading to their adhesion to vascular walls, impeding blood flow and causing the unpredictable, abrupt onset of intense pain episodes in the form of vaso-occlusive crises (VOC) as well as affecting multiple organ systems. The primary aim of this review is to assess the effectiveness of opioid analgesic intervention for pain management in sickle cell disease during an acute painful crisis. A literature search was done electronically on PubMed Central (PMC), PubMed, and Google Scholar databases. The reports included in the study were from 2010 to 2021, and the bibliographies of retrieved studies are included in the references. This systematic review was undertaken as per the Preferred Reporting Items for Systematic Review and Meta-Analysis. This study included reports discussing opioid analgesics in SCD patients during VOC in different settings. After extensive research, there were no clear current opioid treatment patterns described, and our conclusion suggested conducting more evidence-based research to improve the quality of VOC management and outcome.
ABSTRACT
Over the past decade, the consumption of marijuana or any other form of cannabis, whether medically, recreationally, or illegally, has been escalating worldwide. The additive effect of marijuana and the easy availability could make this increasing trend possible for imperceptible outcomes affecting one's physiology on multiple levels. The rationale of this review is to study and enumerate several effects marijuana may have on male reproductive organs, especially in men who are dealing with subfertility or infertility issues. A literature search was done from September 1, 2021, to September 14, 2021, using the following databases: PubMed, Google Scholar, Bielefeld Academic Search Engine (BASE), University of California, Santa Barbara Library, and PubMed Central. The studies included in this review comprised systematic reviews, cross-sectional, case-control, cohort, and longitudinal studies published during 2010-2021 in the English language. After an extensive review of all studies, the quality was assessed using appropriate quality appraisal tools, and 15 eligible reports were identified and included. In-depth research on the final studies concluded that marijuana seems to have specific adverse effects on the sperm parameters, namely, sperm count, concentration, motility, morphology, capacitation, and viability, thus affecting fertility in men. Certain hormone levels, including testosterone, luteinizing hormone, and follicle-stimulating hormone, also drew attention, potentially impacting men's fertility; however, a finite inference could not be substantiated by the studies. Although the studies show significant effects in sperm parameters and organic sexual dysfunction, it is also to be noted that these studies are observational only and are conducted in small groups in multicenter geographical locations where other lifestyle patterns could be confounding. Given this restriction, it is suggested that further human trials on a larger scale be conducted to provide an even more concrete conclusion, especially after considering other factors that may affect the generalization of these trials.
