Navigating through novelties concerning mCRC treatment-the role of immunotherapy, chemotherapy, and targeted therapy in mCRC.

Over the course of nearly six decades since the inception of initial trials involving 5-FU in the treatment of mCRC (metastatic colorectal cancer), our progressive comprehension of the pathophysiology, genetics, and surgical techniques related to mCRC has paved the way for the introduction of novel therapeutic modalities. These advancements not only have augmented the overall survival but have also positively impacted the quality of life (QoL) for affected individuals. Despite the remarkable progress made in the last two decades in the development of chemotherapy, immunotherapy, and target therapies, mCRC remains an incurable disease, with a 5-year survival rate of 14%. In this comprehensive review, our primary goal is to present an overview of mCRC treatment methods following the latest guidelines provided by the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), and the American Society of Colon and Rectal Surgeons (ASCRS). Emphasis has been placed on outlining treatment approaches encompassing chemotherapy, immunotherapy, targeted therapy, and surgery's role in managing mCRC. Furthermore, our review delves into prospective avenues for developing new therapies, offering a glimpse into the future of alternative pathways that hold potential for advancing the field.

The previously undescribed variant of the thyrohyoid muscle and its potential impact on surgical procedures.

The thyrohyoid muscle belongs to the infrahyoid group located in the carotid triangle. It normally originates from thyroid cartilage and inserts into hyoid bone. Quite often, it is continuous with the sternohyoid muscle. Furthermore, there are variants that have their origin in the cricoid cartilage only, however, this occurs very rarely. During anatomical dissection, a two-headed variant of this muscle was found. One head had its origin in the cricoid cartilage and the other in the thyroid cartilage. This variant of thyrohyoid had not been previously described in the available literature. Therefore, we believe that it may be referred to as the cricothyrohyoid muscle. As the thyrohyoideus is often used as a landmark during surgical procedures in the prelaryngeal area and as a muscle graft, a thorough knowledge of its anatomy and variation is extremely important. We speculate that the two-headed version of this muscle may be problematic during surgical procedures in this region, however, it may also provide more options as a muscular graft.

Anti-Th/To Antibodies in Scleroderma: Good Prognosis or Serious Concern?

Systemic sclerosis (SSc) represents a rare and intricate autoimmune connective tissue disease, the pathophysiology of which has not been fully understood. Its key features include progressive fibrosis of the skin and internal organs, vasculopathy and aberrant immune activation. While various anti-nuclear antibodies can serve as biomarkers for the classification and prognosis of SSc, their direct role in organ dysfunction remains unclear. Anti-Th/To antibodies are present in approximately 5% of SSc patients, and are particularly prevalent among those with the limited subtype of the disease. Although the presence of these autoantibodies is associated with a mild course of the disease, there is a strong connection between them and severe clinical manifestations of SSc, including interstitial lung disease, pulmonary arterial hypertension and gastrointestinal involvement. Also, the additional clinical correlations, particularly with malignancies, need further research. Moreover, the disease's course seems to be influenced by antibodies, specific serum cytokines and TLR signaling pathways. Understanding the relationships between presence of anti-Th/To, its molecular aspects and response to treatment options is crucial for the development of novel, personalized therapeutic techniques and should undergo profound analysis in future studies.

Selenium as a Modulator of Redox Reactions in the Prevention and Treatment of Cardiovascular Diseases.

Cardiovascular diseases stand as the predominant global cause of mortality, exerting a profound impact on both life expectancy and its quality. Given their immense public health burden, extensive efforts have been dedicated to comprehending the underlying mechanisms and developing strategies for prevention and treatment. Selenium, a crucial participant in redox reactions, emerges as a notable factor in maintaining myocardial cell homeostasis and influencing the progression of cardiovascular disorders. Some disorders, such as Keshan disease, are directly linked with its environmental deficiency. Nevertheless, the precise extent of its impact on the cardiovascular system remains unclear, marked by contradictory findings in the existing literature. High selenium levels have been associated with an increased risk of developing hypertension, while lower concentrations have been linked to heart failure and atrial fibrillation. Although some trials have shown its potential effectiveness in specific groups of patients, large cohort supplementation attempts have generally yielded unsatisfactory outcomes. Consequently, there persists a significant need for further research aimed at delineating specific patient cohorts and groups of diseases that would benefit from selenium supplementation.

Never undescribed four - headed plantaris muscle.

The plantaris is a small muscle of the superficial posterior compartment of the leg. It originates at the lateral supracondylar line of the femur and the knee joint capsule, from where it continues distally, forming a long and slender tendon distally attached to the calcaneal tuberosity. During standard anatomical dissection four-headed plantaris muscle was found and all of its heads connected to each other as a single muscle belly passing into tendinous structure which was distally attached as a standard plantaris muscle. The first head originated from the popliteal surface of the femur. The second one was originated from distal Kaplan fiber. In turn, the third and fourth heads were proximally attached to the lateral femoral epicondyle. Knowledge about morphological variations is necessary because of its potential clinical significance, which means not only neurovascular compressions, but also surgical procedures.

Hypoglossal Nerve Neuropathies-Analysis of Causes and Anatomical Background.

The hypoglossal nerve is the last, and often neglected, cranial nerve. It is mainly responsible for motor innervation of the tongue and therefore the process of chewing and articulation. However, tumors, aneurysms, dissections, trauma, and various iatrogenic factors such as complications after surgeries, radiotherapy, or airway management can result in dysfunction. Correct differential diagnosis and suitable treatment require a thorough knowledge of the anatomical background of the region. This review presents the broad spectrum of hypoglossal neuropathies, paying particular attention to these with a compressive background. As many of these etiologies are not common and can be easily overlooked without prior preparation, it is important to have a comprehensive understanding of the special relations and characteristic traits of these medical conditions, as well as the most common concomitant disorders and morphological traits, influencing the clinical image. Due to the diverse etiology of hypoglossal neuropathies, specialists from many different medical branches might expect to encounter patients presenting such symptoms.

Two-headed extensor digitorum longus with coexisting additional tendinous slips.

The extensor digitorum longus is a source of much anatomic variation, mostly related with extra tendinous slips or their unusual insertions. This report describes a new configuration of the extensor digitorum longus with two heads and two main tendons which bifurcate into five slips. These slips undergo further divisions and establish connections between the each other. Our findings provide a greater insight into the intricacies of human morphology.

A very rare case of a thoracobrachialis muscle.

The anterior arm compartment includes the biceps brachii muscle, brachialis muscle, and coracobrachialis muscle, and they are characterized by different morphological variations. During standard anatomical dissection of right upper limb, an variant muscle was found. It originated from the fascia covering the long head of biceps brachii and from the tendon of pectoralis major muscle. It also connected to the brachial fascia. It also demonstrated a long thin tendon which was distally attached to the medial epicondyle of humerus. Knowledge about the morphological variations in this region is clinically important because of their direct correlation with neurovascular structures, which may lead to pathologies such as tingling, muscle weakness, paresthesia, and loss of sensation.

Radial nerve compression: anatomical perspective and clinical consequences.

The radial nerve is the biggest branch of the posterior cord of the brachial plexus and one of its five terminal branches. Entrapment of the radial nerve at the elbow is the third most common compressive neuropathy of the upper limb after carpal tunnel and cubital tunnel syndromes. Because the incidence is relatively low and many agents can compress it along its whole course, entrapment of the radial nerve or its branches can pose a considerable clinical challenge. Several of these agents are related to normal or variant anatomy. The most common of the compressive neuropathies related to the radial nerve is the posterior interosseus nerve syndrome. Appropriate treatment requires familiarity with the anatomical traits influencing the presenting symptoms and the related prognoses. The aim of this study is to describe the compressive neuropathies of the radial nerve, emphasizing the anatomical perspective and highlighting the traps awaiting physicians evaluating these entrapments.

Coexistence of accessory band with the second type of extensor hallucis longus.

The main muscles responsible for extension of the toes are the extensor digitorum longus and extensor hallucis longus. Morphological variants of both of these muscles are mostly related to the numbers of tendons and their unusual points of insertion. The case presented shows an accessory band deriving from the extensor digitorum longus and fusing with the extensor hallucis longus, a concomitant additional tendon of the latter inserting to the proximal phalanx of the hallux. Knowledge of these anatomical patterns is important not only from the anatomical but also the clinical point of view and can be useful in lower limb surgery.

Possible points of compression of the ulnar nerve: Tricks and traps that await clinicians from an anatomical point of view.

The ulnar nerve can be subject to numerous types of compression. The most common are cubital tunnel and ulnar tunnel syndromes, but there are many others with more uncommon etiologies. The existence of additional communicating branches, median nerve involvement, various types of injuries, and unusual anatomical variations can be a challenge for both diagnosis and treatment. This review presents a comprehensive depiction of ulnar nerve entrapment syndromes with particular reference to their anatomical background, risk factors, and clinical evaluation. Even common disorders can result from atypical morphological changes. It is important to be familiar with them as it is a key ability in daily medical practice.