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Gut and Liver Mar 2018Diverticular disease is one of the most common conditions in the Western world and one of the most common findings identified at colonoscopy. Recently, there has been a... (Review)
Review
Diverticular disease is one of the most common conditions in the Western world and one of the most common findings identified at colonoscopy. Recently, there has been a significant paradigm shift in our understanding of diverticular disease and its management. The pathogenesis of diverticular disease is thought to be multifactorial and include both environmental and genetic factors in addition to the historically accepted etiology of dietary fiber deficiency. Symptomatic uncomplicated diverticular disease (SUDD) is currently considered a type of chronic diverticulosis that is perhaps akin to irritable bowel syndrome. Mesalamine, rifaximin and probiotics may achieve symptomatic relief in some patients with SUDD, although their role(s) in preventing complications remain unclear. Antibiotic use for acute diverticulitis and elective prophylactic resection surgery are considered more individualized treatment modalities that take into account the clinical status, comorbidities and lifestyle of the patient. Our understanding of the pathogenesis of diverticular disease continues to evolve and is likely to be diverse and multifactorial. Paradigm shifts in several areas of the pathogenesis and management of diverticular disease are explored in this review.
Topics: Colonoscopy; Diverticular Diseases; Humans; Patient Care Management
PubMed: 28494576
DOI: 10.5009/gnl16552 -
Frontiers in Immunology 2022Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) characterized by destruction of the myelin sheath structure. The loss of... (Review)
Review
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) characterized by destruction of the myelin sheath structure. The loss of myelin leads to damage of a neuron's axon and cell body, which is identified as brain lesions on magnetic resonance image (MRI). The pathogenesis of MS remains largely unknown. However, immune mechanisms, especially those linked to the aberrant lymphocyte activity, are mainly responsible for neuronal damage. Th1 and Th17 populations of lymphocytes were primarily associated with MS pathogenesis. These lymphocytes are essential for differentiation of encephalitogenic CD8 T cell and Th17 lymphocyte crossing the blood brain barrier and targeting myelin sheath in the CNS. B-lymphocytes could also contribute to MS pathogenesis by producing anti-myelin basic protein antibodies. In later studies, aberrant function of Treg and Th9 cells was identified as contributing to MS. This review summarizes the aberrant function and count of lymphocyte, and the contributions of these cell to the mechanisms of MS. Additionally, we have outlined the novel MS therapeutics aimed to amend the aberrant function or counts of these lymphocytes.
Topics: Animals; Central Nervous System; Encephalomyelitis, Autoimmune, Experimental; Multiple Sclerosis; Myelin Sheath; Th17 Cells
PubMed: 36211343
DOI: 10.3389/fimmu.2022.996469 -
Ceska Gynekologie 2019To summarize the current knowledge about pathogenesis, diagnostics, symptomatology and the treatment of adenomysis. (Review)
Review
OBJECTIVE
To summarize the current knowledge about pathogenesis, diagnostics, symptomatology and the treatment of adenomysis.
DESIGN
Review article.
SETTING
The Centre of Assisted Reproduction, ISCARE I.V.F., Prague.
METHODS
Analysis of literature and current studies.
RESULTS
This article reviews etiology, diagnostics and classification of adenomyosis, medical and surgical management options and the fertility implication of adenomyosis.
CONCLUSION
Uterine adenomyosis is characterized by the presence of endometrial glands in myometrium and usually manifests by pelvic pain, abnormal uterine bleeding or infertility. Although adenomyosis and endometriosis share a number of features, they are considered to be two different entities. Recent improvements of imaging techniques such as transvaginal ultrasound and magnetic resonance imaging have affected the detection of adenomyosis. Adenomyosis has a negative impact on IVF results.
Topics: Adenomyosis; Endometriosis; Female; Humans; Infertility, Female; Pelvic Pain; Uterine Diseases; Uterine Hemorrhage; Uterus
PubMed: 31324117
DOI: No ID Found -
Best Practice & Research. Clinical... Jun 2021Psoriatic arthritis (PsA) is a heterogenous systemic inflammatory disorder which affects peripheral joints (PsA) and skin (psoriasis (Ps)), but also causes inflammation... (Review)
Review
Psoriatic arthritis (PsA) is a heterogenous systemic inflammatory disorder which affects peripheral joints (PsA) and skin (psoriasis (Ps)), but also causes inflammation at entheseal sites, digits (dactylitis) and the axial skeleton. Over the past decade, there have been considerable advances both in our understanding of the pathogenesis of PsA and in the treatment of its diverse manifestations. This article reviews our current knowledge of the pathogenesis of PsA, and how genetic pre-disposition coupled with mechanical stress may influence the development of the pathognomonic features of PsA including enthesitis and osteoproliferation, with concomitant osteoporosis and erosive disease. We consider factors that influence the development of PsA in patients with Ps, and how improving our knowledge of the phenotypes of PsA may ultimately facilitate our goal of precision medicine, a key unmet need as defined by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis.
Topics: Arthritis, Psoriatic; Enthesopathy; Humans; Inflammation; Psoriasis
PubMed: 34108102
DOI: 10.1016/j.berh.2021.101694 -
International Journal of Molecular... Mar 2023Vitiligo is an acquired hypopigmentation of the skin due to a progressive selective loss of melanocytes; it has a prevalence of 1-2% and appears as rounded,... (Review)
Review
Vitiligo is an acquired hypopigmentation of the skin due to a progressive selective loss of melanocytes; it has a prevalence of 1-2% and appears as rounded, well-demarcated white macules. The etiopathology of the disease has not been well defined, but multiple factors contribute to melanocyte loss: metabolic abnormalities, oxidative stress, inflammation, and autoimmunity. Therefore, a convergence theory was proposed that combines all existing theories into a comprehensive one in which several mechanisms contribute to the reduction of melanocyte viability. In addition, increasingly in-depth knowledge about the disease's pathogenetic processes has enabled the development of increasingly targeted therapeutic strategies with high efficacy and fewer side effects. The aim of this paper is, by conducting a narrative review of the literature, to analyze the pathogenesis of vitiligo and the most recent treatments available for this condition.
Topics: Humans; Vitiligo; Hypopigmentation; Melanocytes; Skin; Oxidative Stress
PubMed: 36902341
DOI: 10.3390/ijms24054910 -
Journal of the American Academy of... Jul 2017Vitiligo is a common autoimmune disease that progressively destroys melanocytes in the skin, resulting in the appearance of patchy depigmentation. This disfiguring... (Review)
Review
Vitiligo is a common autoimmune disease that progressively destroys melanocytes in the skin, resulting in the appearance of patchy depigmentation. This disfiguring condition frequently affects the face and other visible areas of the body, which can be psychologically devastating. The onset of vitiligo often occurs in younger individuals and progresses for life, resulting in a heavy burden of disease and decreased quality of life. Presentation patterns of vitiligo vary, and recognition of these patterns provides both diagnostic and prognostic clues. Recent insights into disease pathogenesis offer a better understanding of the natural history of the disease, its associations, and potential for future treatments. The first article in this continuing medical education series outlines typical and atypical presentations of vitiligo, how they reflect disease activity, prognosis, and response to treatment. Finally, we discuss disease associations, risk factors, and our current understanding of disease pathogenesis.
Topics: Humans; Vitiligo
PubMed: 28619550
DOI: 10.1016/j.jaad.2016.10.048 -
Metabolism: Clinical and Experimental Apr 2016The prognosis of diabetic ketoacidosis has undergone incredibly remarkable evolution since the discovery of insulin nearly a century ago. The incidence and economic... (Review)
Review
The prognosis of diabetic ketoacidosis has undergone incredibly remarkable evolution since the discovery of insulin nearly a century ago. The incidence and economic burden of diabetic ketoacidosis have continued to rise but its mortality has decreased to less than 1% in good centers. Improved outcome is attributable to a better understanding of the pathophysiology of the disease and widespread application of treatment guidelines. In this review, we present the changes that have occurred over the years, highlighting the evidence behind the recommendations that have improved outcome. We begin with a discussion of the precipitants and pathogenesis of DKA as a prelude to understanding the rationale for the recommendations. A brief review of ketosis-prone type 2 diabetes, an update relating to the diagnosis of DKA and a future perspective are also provided.
Topics: Animals; Diabetes Mellitus; Diabetic Ketoacidosis; Humans; Incidence
PubMed: 26975543
DOI: 10.1016/j.metabol.2015.12.007 -
International Journal of Molecular... Nov 2022The incidence of gallstone disease has increased in recent years. The pathogenesis of cholelithiasis is not fully understood. The occurrence of the disease is influenced... (Review)
Review
The incidence of gallstone disease has increased in recent years. The pathogenesis of cholelithiasis is not fully understood. The occurrence of the disease is influenced by both genetic and environmental factors. This article reviews the literature on cholelithiasis in children, with the exception of articles on hematological causes of cholelithiasis and cholelithiasis surgery. The aim of this review is to present the latest research on the pathogenesis of gallstone disease in children. The paper discusses the influence of all factors known so far, such as genetic predisposition, age, infections, medications used, parenteral nutrition, and comorbidities, on the development of gallstone disease. The course of cholelithiasis in the pediatric population is complex, ranging from asymptomatic to life-threatening. Understanding the course of the disease and predisposing factors can result in a faster diagnosis of the disease and administration of appropriate treatment.
Topics: Humans; Child; Adolescent; Cholelithiasis; Causality; Comorbidity; Genetic Predisposition to Disease
PubMed: 36362164
DOI: 10.3390/ijms232113376 -
International Journal of Molecular... Sep 2023Interstitial lung disease (ILD) is one of the most serious extra-articular complications of rheumatoid arthritis (RA), which increases the mortality of RA. Because the... (Review)
Review
Interstitial lung disease (ILD) is one of the most serious extra-articular complications of rheumatoid arthritis (RA), which increases the mortality of RA. Because the pathogenesis of RA-ILD remains poorly understood, appropriate therapeutic strategies and biomarkers have not yet been identified. Thus, the goal of this review was to summarize and analyze the reported data on the etiology and pathogenesis of RA-ILD. The incidence of RA-ILD increases with age, and is also generally higher in men than in women and in patients with specific genetic variations and ethnicity. Lifestyle factors associated with an increased risk of RA-ILD include smoking and exposure to pollutants. The presence of an anti-cyclic citrullinated peptide antibody, high RA disease activity, and rheumatoid factor positivity also increase the risk of RA-ILD. We also explored the roles of biological processes (e.g., fibroblast-myofibroblast transition, epithelial-mesenchymal transition, and immunological processes), signaling pathways (e.g., JAK/STAT and PI3K/Akt), and the histopathology of RA involved in RA-ILD pathogenesis based on published preclinical and clinical models of RA-ILD in animal and human studies.
Topics: Male; Animals; Humans; Female; Phosphatidylinositol 3-Kinases; Arthritis, Rheumatoid; Lung Diseases, Interstitial; Risk Factors; Rheumatoid Factor
PubMed: 37833957
DOI: 10.3390/ijms241914509 -
Annual Review of Pathology Jan 2020Malaria remains a major public health threat in tropical and subtropical regions across the world. Even though less than 1% of malaria infections are fatal, this leads... (Review)
Review
Malaria remains a major public health threat in tropical and subtropical regions across the world. Even though less than 1% of malaria infections are fatal, this leads to about 430,000 deaths per year, predominantly in young children in sub-Saharan Africa. Therefore, it is imperative to understand why a subset of infected individuals develop severe syndromes and some of them die and what differentiates these cases from the majority that recovers. Here, we discuss progress made during the past decade in our understanding of malaria pathogenesis, focusing on the major human parasite .
Topics: Africa South of the Sahara; Child; Child, Preschool; Disease Susceptibility; Humans; Malaria; Malaria, Falciparum; Plasmodium falciparum; Severity of Illness Index
PubMed: 31648610
DOI: 10.1146/annurev-pathmechdis-012419-032640