Cytochrome P450 (CYP) epoxygenases, a multi-gene superfamily of hemecontaining enzymes, are commonly known to metabolize endogenous arachidonic acid (AA) to epoxyeicosatrienoic acids (EETs). The role of CYPs is mostly studied in liver drugs metabolism, cardiac pathophysiology, and hypertension fields. Particularly, the biological functions of these enzymes have increasingly attracted a growing interest in cancer biology. Most published studies on CYPs in cancer have been limited to their role as drug metabolizing systems. The activity of these enzymes may affect drug pharmacokinetics and bioavailability as well as exogenous compounds turnover. Some CYP isoforms are selectively highly expressed in tumors, suggesting a potential mechanistic role in promoting resistance to chemotherapy. Majority of drugs elicit their effects in extrahepatic tissues whereby their metabolism can significantly determine treatment outcome. Nonetheless, the role of extrahepatic CYPs is not fully understood and targeting these enzymes as effective anti-cancer therapies are yet to be developed. This review article summarizes an up-to-date body of information from published studies on CYP enzymes expression levels and pathophysiological functions in human normal and malignant gastrointestinal (GI) tract tissues. Specifically, we reviewed and discussed the current research initiatives by emphasizing on the clinical significance and the pathological implication of CYPs in GI malignancies of esophagus, stomach, and colon.
The aim: Taking into consideration the increase in the frequency of urgent C-sections in the second stage of labor and significant technical difficulties in the extraction of deeply impacted fetal head during this operation, the aim of our work was to analyze the current published biomedical data to identify the optimal technical strategies for conducting this type of surgical interventions. Materials and methods: The search and analysis of current clinical data available in PubMed was performed. We analyzed 9 retrospective and randomized prospective studies with collected data from a total of 974 women (2002-2019). Conclusions: Analysis of nine prospective and retrospective studies, comparing reverse breech extraction with abdominovaginal technique, revealed a significant advantage and safety of reverse breech extraction. This procedure has been associated with the decrease of traumatic uncontrolled extension of uterine incisions in 2.3-10 times, the time of surgical intervention decreased by 6.5-33 minutes, and intraoperative blood loss was less by 149.5-444 ml as compared with abdominovaginal delivery. Moreover, less intra- and postoperative complications were observed. In conclusion, reverse breech extraction during cesarean section with impacted fetal head is a safe delivery technique that helps to significantly decrease the incidence of maternal complications.
Мета дослідження – вивчення обізнаності жіночого населення Львівської області про роль фолієвої кислоти (ФК) у попередженні вроджених вад розвитку плода (ВВР). Матеріали та методи. Проведено опитування вагітних жінок Львівської області та аналіз 811 анкет респондентів. Вивчали питання стосовно вживання зазначеного препарату: дози (100, 200, 400 або 500 мкг), до та під час даної вагітності, тривалості прийому препарату, до зачаття та перші три місяці вагітності, а також обізнаності населення відносно преконцепційної дії фолієвої кислоти. Результати дослідження та їх обговорення. Аналіз даних анкет показав, що з 811 жінок проживали в місті 622 (76,69 %), а 189 (23,31 %) – в селі. Вивчення паритету вагітності показало, що значно більше було жінок із І та ІІ вагітністю (48,20 % та 33,97 % відповідно). Найбільш поінформованими про значення ФК були жінки, вагітні вперше (30,83 %) та вдруге (25,40 %), з них значно частіше були жительки міста. Більшість респондентів отримала знання про ФК від медиків – 58,08 %, причому достовірно більше цих жінок було з міста, ніж із села (46,0 % та 12,08 % відповідно, Р<0,001). Лише 40,44 % вживали ФК до вагітності протягом від одного до трьох місяців. Всього близько 1/3 (37,73 %) жінок вживали ФК у дозі 400 мкг. Причому 26,26 % респондентів застосовували препарат протягом 2 місяців до вагітності, та 41,92 % – трьох місяців під час вагітності. Значно частіше це були мешканки міста, ніж села (Р<0,001). Висновки. Встановлено, що серед жіночого населення Львівської області поінформованість про фолієву кислоту як кращу справжню профілактику вроджених аномалій розвитку плода є недостатньою. Це стосується даних про сам препарат, його дозу прийому та термінів і тривалості вживання.
Aim. The paper aims at reviewing publications and analyzing a clinical case of Henoch-Schonlein purpura in a pregnant patient. This pathology is extremely rare in pregnancy (solely about 20 cases reported in the available literature) Materials and Methods. A systematic literature search was performed in Pubmed and other sources on peculiarities of gestation in Henoch-Schonlein purpura. A case of Henoch-Schonlein purpura in a pregnant woman, who delivered in 2020 in Lviv Maternity Hospital №1 is presented. Results and Discussion. Henoch-Shonlein purpura is extremely rare disease in pregnant women. Only about 20 cases are presented in all available literature. Pregnancy course in described cases was usually favorable. Most patients were delivered by cesarean section for different reasons. About 25% of presented cases were complicated by nephrotic syndrome and superposition of preeclampsia, requiring preterm delivery. No case of placental vasculitis was detected at histological examination of placentas. Our case report: 33-years old patient, primigravida. Henoch-Schonlein purpura diagnosed 8 years ago. The course of the disease was chronic recurrent with predominant skin and joints lesions. Nephrotic syndrome was observed 4 years before pregnancy for last time. The patient continuously received corticosteroid therapy. Course of pregnancy was complicated by mild preeclampsia in the third trimester. A healthy girl weighting 3200g was delivered physiologically at term. No complications were observed in the postpartum period. Conclusions. Hemorrhagic vasculitis (Henoch-Shonlein purpura) is an extremely rare disease in pregnancy. In absence of nephrotic syndrome, the course of pregnancy and delivery is favorable, but these patients require\h thorough monitoring for early detection of nephrotic syndrome and/or preeclampsia manifestations.
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