Hepatocellular carcinoma (HCC) is the most common primary liver cancer with an increasing worldwide mortality rate. Cholangiocarcinoma (CCA) is the second most common primary liver cancer. In both types of cancers, early detection is very important. Biomarkers are a relevant part of diagnosis, enabling non-invasive detection and control of cancer recurrence, as well as in the application of screening tests in high-risk groups. Furthermore, some of these biomarkers are useful in controlling therapy and treatment selection. Detection of some markers presents higher sensitivity and specificity in combination with other markers when compared with a single detection. Some gene aberrations are also prognostic markers in the two types of cancers. In the following review, we discuss the most common biomarkers and genetic markers currently being used in the diagnosis of hepatocellular carcinoma and cholangiocarcinoma.
Epilepsy is an important medical problem with approximately 50 million patients globally. No more than 70% of epileptic patients will achieve seizure control after antiepileptic drugs, and several epileptic syndromes, including Lennox-Gastaut syndrome (LGS), are predisposed to more frequent pharmacoresistance. Ketogenic dietary therapies (KDTs) are a form of non-pharmacological treatments used in attempts to provide seizure control for LGS patients who experience pharmacoresistance. Our review aimed to evaluate the efficacy and practicalities concerning the use of KDTs in LGS. In general, KDTs are diets rich in fat and low in carbohydrates that put the organism into the state of ketosis. A classic ketogenic diet (cKD) is the best-evaluated KDT, while alternative KDTs, such as the medium-chain triglyceride diet (MCT), modified Atkins diet (MAD), and low glycemic index treatment (LGIT) present several advantages due to their better tolerability and easier administration. The literature reports regarding LGS suggest that KDTs can provide ≥50% seizure reduction and seizure-free status in a considerable percentage of the patients. The most commonly reported adverse effects are constipation, diarrhea, and vomiting, while severe adverse effects such as nephrolithiasis or osteopenia are rarely reported. The literature review suggests that KDTs can be applied safely and are effective in LGS treatment.
Aluminium (Al) is the most ubiquitous metal in the Earth’s crust. Even though its toxicity is well-documented, the role of Al in the pathogenesis of several neurological diseases remains debatable. To establish the basic framework for future studies, we review literature reports on Al toxicokinetics and its role in Alzheimer’s disease (AD), autism spectrum disorder (ASD), alcohol use disorder (AUD), multiple sclerosis (MS), Parkinson’s disease (PD), and dialysis encephalopathy (DE) from 1976 to 2022. Despite poor absorption via mucosa, the biggest amount of Al comes with food, drinking water, and inhalation. Vaccines introduce negligible amounts of Al, while the data on skin absorption (which might be linked with carcinogenesis) is limited and requires further investigation. In the above-mentioned diseases, the literature shows excessive Al accumulation in the central nervous system (AD, AUD, MS, PD, DE) and epidemiological links between greater Al exposition and their increased prevalence (AD, PD, DE). Moreover, the literature suggests that Al has the potential as a marker of disease (AD, PD) and beneficial results of Al chelator use (such as cognitive improvement in AD, AUD, MS, and DE cases).
Introduction and objective. Depression is a disorder that medical students are subjected to. The aim of the research was to investigate the occurrence of subjective feeling of depressive symptoms among Polish medical students during the course of medical studies and to determine predictors of this phenomenon that are associated with studies and lifestyle. Material and method. The research tool was author's questionnaire. 1023 medical students from each year of medical education and different Polish universities took part in the study. Results. 52.79% of the respondents had noticed symptoms that might had pointed to depression during the course of their medical studies. The research suggests that predictors of subjective feeling of depressive symptoms among medical students are: repeating a university subject, repeating a year in university, low selfassessment of academic performance during studying, considering dropping out of university, low satisfaction from the choice of studying medicine, reaching for alcohol in order to destress or discharge negative emotions, not having interests that enable to relax, not doing sports regularly, not participating in social gatherings often enough, not sleeping enough, having problems with maintaining stable body weight and not being religious. Conclusions. There are many lifestyle and studies connected factors associated with depressive symptoms among Polish medical students. The study suggests that it is important for students and their communities to pay attention to the emergence of them in order to improve the well-being of students.
Introduction and objective. Depression is a common mental disorder that affects over 264 million people worldwide. Medical students are at a particularly high risk of this disease. The aim of the study was to investigate the prevalence of depression among Polish medical students and to determine predictors of this disease that are related to student’s lifestyle. Material and method. A total of 1023 medical students took part in the study. The research tool included a Polish version of the PHQ-9 questionnaire and author’s questions which concerned sociodemographic characteristics of the investigated group and analyzed factors. Answers were collected in the April of 2020. Results. About a half of the students (51.61%, 95% CI: 48.50 – 54.72) were found to have major depression (PHQ score ≥ 10). 30.21% of the students had mild depressive symptoms, 26.00% – moderate depressive symptoms and 15.05% – moderately severe depressive symptoms. 10.56% of the participants had symptoms of severe depression. A statistically significant relationship was found between major depression and: frequent feelings of loneliness, not doing sports regularly, not getting enough sleep, not participating in social meetings often enough, having problems with maintaining stable body weight, using alcohol in order to relieve stress or negative emotions and being non-religious. Conclusions. Depression among medical students in Poland is common. There are many lifestyle-linked predictors which are associated with this disease in the above-mentioned group. It is crucial to take actions aimed at reducing the high prevalence rates of depression among medical students in Poland, such as introducing routine screening for depression and creating resources that would enable students to obtain help.
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