Several theories suggest an inverse association between increasing adiposity, particularly abdominal fat, and low vitamin D levels. As a result, several routes are likely to impact how vitamin D, obesity, and metabolic syndrome (MetS) interact. This systematic study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. A comprehensive PubMed, PubMed Central, Google Scholar, and ScienceDirect database search was conducted for published papers over the previous five years. Studies were identified using the following criteria 1) participants, interventions, and outcomes (PIO) components, 2) free full text, 3) studies published in English, and 4) human studies, including systematic and narrative reviews and cross-sectional, observational studies, were among the inclusion and exclusion criteria. In total, 151 articles were returned, and 16 duplicates were rejected. After verifying the titles and abstracts of these records using the review's PIO components and eligibility criteria, 17 received a 70% or above score. On review of the literature, the release of adiponectin from fatty tissues was inversely correlated with body weight and BMI suggesting a link between vitamin D deficiency and insulin resistance.
Although overall survival rates of patients infected with human immunodeficiency virus (HIV) have been significantly improved by antiretroviral therapy (ART), chronic comorbidities associated with HIV result in a worsening quality of life. Pulmonary arterial hypertension (PAH) is the most prevalent comorbidity associated with HIV infection. Despite low viremia and a non-replicative state maintained by ART, few people develop PAH. Previous data from animal models and human pulmonary microvascular endothelial cells (HPMVECs) suggests a constellation of events occurring during the propagation of HIV-associated PAH (HIV-PAH). However, these studies have not successfully isolated HIV virions, HIV-DNA, protein 24 antigen (p24), or HIV-RNA from the pulmonary endothelial cells (ECs). It provides an insight into an ongoing inflammatory process that could be attributed to viral proteins. Several studies have demonstrated the role of viral proteins on vascular remodeling. A composite of chronic inflammatory changes mediated by cytokines and growth factors along with several inciting risk factors such as Hepatitis C virus (HCV) coinfection, genetic factors, male predominance, illegal drug usage, and duration of HIV infection have led to molecular changes that result in an initial phase of apoptosis followed by the formation of apoptotic resistant hyperproliferative ECs with altered phenotype. This study aims to identify the risk factors and mechanisms behind HIV-PAH pathobiology at the host-pathogen interface at the intracellular level.
Magnetic resonance imaging (MRI) and endorectal ultrasound (ERUS) are essential imaging modalities to assess the depth of tumour invasion (T-staging) in rectal cancer preoperative staging. Accurate T-staging is critical for rectal cancer prognosis and has substantial importance in the determination of appropriate treatment strategies for rectal tumours. There seems to be a knowledge gap in the published literature regarding the most appropriate imaging modality for the preoperative staging of rectal cancer. The purpose of this study was to determine the most appropriate imaging technique for the preoperative T-staging of rectal cancer by comparing the MRI and ERUS staging. In this study, we performed a literature review of studies published in the last 10 years and compared the accuracy, sensitivity, and specificity of ERUS and MRI for the preoperative T-staging of rectal cancer with the aim of identifying the most appropriate imaging modality. The studies reviewed were selected by a rigorous literature search of academic databases. Three electronic databases (PubMed, CINAHL, and Scopus) were searched, and articles were identified. Further rescreening of the articles for those that met the inclusion criteria and searching of the citations of the articles produced eleven journal articles used in this research. Endorectal ultrasound produces accurate results for the T-staging of early rectal cancer, particularly T1 and T2, and has the ability to show the layers of the bowels more clearly in early-stage rectal cancer. However, MRI shows more accurate results for the staging of locally advanced tumours such as advanced T3 and T4 and is particularly important when estimating tumour invasion into the mesorectum, which is very important for the prognostication and survival of patients with rectal cancer. MRI has low accuracy for differentiating early T3 tumours from T1 or T2 with desmoplastic reactions, and therefore, is more likely to overstage these tumours.
Down's syndrome (DS) is the most well-known chromosomal abnormality characterized by an extra chromosome 21 and multiple systemic issues. The higher production of amyloid precursor protein (APP), the precursor peptide of beta-amyloid, predisposes persons with DS to early Alzheimer's disease (AD). The prevalence of dementia has increased as a function of the extended life expectancy of persons with DS. Because we know little about the treatment of dementia in persons with DS, this review focuses on the pathophysiology and management strategies to improve the overall quality of life.
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