Antitumorigenic action of nelfinavir: Effects on multiple myeloma and hematologic malignancies (Review).

Protease inhibitors (PIs) inhibit HIV­1 and HIV­2 proteases, impeding virus replication and liberation of viral elements from infected cells. In human immunodeficiency virus (HIV) subjects receiving PI­based treatment, an impressive decrease in the amount of HIV­associated cancers, unconnected to viral burden or CD4 amount was observed. Research has reported that PIs have influence on cancer proliferation, spread, and survival as an effect on endoplasmic reticulum stress, proteasome, NF­κB and Akt signalling. Nelfinavir (NFV) is a nonpeptidic PI that functions by connecting to the catalytic site of the HIV protease, thus stopping the cleavage of viral polyprotein into complete, operative proteins that are fundamental for viral survival. NFV, currently not frequently employed for antiretroviral treatment, has demonstrated noteworthy off target effects in tumor patients with or without HIV disease. NFV appears to cause cell death in tumor cells by different mechanisms, which include necrosis, apoptosis and autophagy. In this review, data from preclinical research and clinical trials are reported and the mechanisms of action of NFV and their results in the treatment of hematologic malignancies, such as acute myeloid leukemia, chronic lymphoid leukemia, and diffuse large B cell lymphoma, and especially in patients with multiple myeloma are examined. In the future, experimental studies may help identify the role of NFV in cancer treatment and may promote the application of this drug into daily clinical practice.

Role of the microbiota in hematologic malignancies.

Human beings are inhabited by innumerable microorganisms that interrelate with the host in a reciprocal way, establishing a combined and efficient ecosystem - the microbiota - that can affect healthiness as well as disease. There is evidence that the conformation of the microbiota may influence, and is controlled by, the human immune system. Microbes existing in human tissues offer a multiplicity of advantages that participate in functional actions in the host through the adjustment of essential processes such as immunity, signal transduction, and metabolism. The imbalance of this microbial structure has been connected with the pathogenesis and progression of cancer. We reviewed the present knowledge of the diverse microbial ecosystems and we investigated their potential link to carcinogenesis, and the possibility of using advantageous microbes in controlling and preventing hematologic malignancies.

Use of squaric acid dibutylester (SADBE) for cutaneous warts in children.

We evaluated the efficacy of squaric acid dibutylester (SADBE) contact immunotherapy for the treatment of warts on a series of 188 children. Included in the study were those children who satisfied at least two of the following criteria: single or multiple sites with several warts, warts resistant to repeated medical and/or surgical treatments, recurrent multiple warts, and patient or parent refusal to undergo destructive or surgical treatment. Excluded from the study were children with single warts or with flat warts located exclusively on the face and children less than 2 years of age. Treatment consisted of twice weekly applications of serial dilutions of SADBE (0.03-3%) for no more than 10 weeks. Of the 148 children who completed the study, 124 (84%) showed complete clinical resolution with no significant side effects. Of those with total clinical resolution, 101 completed a 24-month follow-up with no relapses. Twenty-four (16%) children were nonrespondent. No apparent correlation between treatment response and age, gender, anatomic site, lesion type, or atopy was found. Contact immunotherapy with SADBE is a relatively safe and effective alternative treatment in the management of multiple and resistant cutaneous warts in children.

Transient leucoderma appearing in an untreated area following contact immunotherapy for alopecia areata.

One of the possible unwanted side effects following contact immunotherapy of alopecia areata is skin hypopigmentation, either in the form of a transient, post-inflammatory hypopigmentation or as the development of a persistent, depigmented patch. A case of leucoderma occurring on the forehead of a 16-year-old girl following application of squaric acid dibutylester to the scalp for the treatment of alopecia areata is described. Past medical and family history were negative for vitiligo and autoimmune disorders. The hypopigmented patch was distant from the scalp area where squaric acid dibutylester had been applied, and it was not preceded by any sign of eczema, erythema or itch in the same area. Moreover, it faded as soon as treatment was discontinued. A 4-year follow-up revealed no evidence of vitiligo. In conclusion, the possible occurrence of a transient leucoderma in untreated areas should be included among the side effects of contact immunotherapy of alopecia areata with squaric acid dibutylester.

Spiritual dimension in the dynamic relationship with the "helping professions".

The attention given to the spiritual dimension in the "helping professions" practice represents a major step for a coherent approach toward the ethical aspects in the resolving individual and familial conflicts; furthermore they can be used as a key in understanding dysfunctional relationship. Psychiatry interest for religion and mysticism must be considered within a wider framework of cultural changes of our society, from which neither religion, understood as a system of faith, nor medicine, as an answer to human suffering could remain indifferent. The evaluation of this aspect prevents the occurrence of "burn-out" syndrome in the "helping professions" workers, because it would give them the opportunity to a greater spiritual growth with expression of empathy, respect and better understanding of help request from their patients.