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Pulmonary embolism (PE) presents with a spectrum of symptoms, ranging from asymptomatic cases to life-threatening events. Common symptoms include sudden dyspnea, chest pain, limb swelling, syncope, and hemoptysis. Clinical presentation varies based on thrombus burden, demographics, and time to presentation. Diagnostic evaluation involves assessing symptoms, physical examination findings, and utilizing laboratory tests, including D-dimer. Risk stratification using tools like Wells score, Pulmonary Embolism Severity Index, and Hestia criteria aids in determining the severity of PE. PE is categorized based on hemodynamic status, temporal patterns, and anatomic locations of emboli to guide in making treatment decisions. Risk stratification plays a crucial role in directing management strategies, with elderly and comorbid individuals at higher risk. Early identification and appropriate risk stratification are essential for effective management of PE. As we delve into this review article, we aim to enhance the knowledge base surrounding PE, contributing to improved patient outcomes through informed decision-making in clinical practice.
RESUMO
Background: The benefits of social support are often overlooked in common management components of cardiovascular diseases. The Multidimensional Scale of Perceived Social Support (MSPSS) is self-administered and scores perceived social support (PSS). We sought to identify PSS among cardiovascular patients and the effects it may have on quality of life (QoL) and treatment compliance. Methods: A total of 96 patients were evaluated using the MSPSS in 3 categories: significant other (SO), family, and friends using a 7-point Likert scale. A supplemental lifestyle survey assessed various demographics, subjective QoL, and compliance with treatment plans. Results: Patients with high QoL reported a higher PSS Likert score in the family support category. Patients who were compliant with appointments and had high substance use avoidance (tobacco, alcohol, illicit drugs) had a higher PSS Likert score in the friend support and higher PSS Likert score in support from SO and family categories, respectively. No difference in PSS was found in compliance with medications, diet, and exercise. Conclusion: Various social support categories are directly associated with higher QoL, adherence to appointments, and substance abuse avoidance.
RESUMO
The PI3Kinase/AKT/mTOR signaling module is implicated in various cellular functions including cell survival, growth and proliferation, glucose metabolism, apoptosis, migration, and angiogenesis. Increased expression of AKT and its up- and downstream regulators is linked to several types of cancer. Aberrant expression of AKT is observed in nearly 60% of melanomas culminating in apoptosis resistance via deactivation of apoptotic molecules Bad and Cas-pase-9. Through cross-talk with NF-κB, ERK1/2, JNK and p38MAPK signaling pathways, AKT induces a plethora of cellular effects often leading to tumor development and progression. Due to frequently observed resistance to other common cancer treatments such as chemotherapy, immunotherapy, and radiation, and the detrimental consequences of constitutive activation of the PI3Kinase/AKT/mTOR signaling module, targeted inhibition of the effectors and substrates involved in this module has become a viable and attractive option for molecular targeted therapy in melanoma. Pharmacological inhibitors of various components of this module, either alone or in combination with other agents, have shown significant decrease in proliferation, tumorigenesis, cell growth and survival of various tumors in phases I and II clinical trials. Some inhibitors have even received their Food and Drug Administration (FDA) approval. This review summarizes the current knowledge on this module, its cross-talk with other major cell survival pathways and its targeted inhibition for therapeutic purposes in melanoma.
