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Alzheimer's disease (AD) is a neurodegenerative disease primarily affecting individuals aged 65 or above. AD leads to progressive cognitive and functional decline, affecting daily life activities. Amyloid plaques are the pathological hallmark of AD, resulting in the loss of neurons and their connections in the brain. For years, patients with AD were treated with pharmacotherapies having only symptomatic effects. Till 2023, no drug was approved for disease-modifying potential. The Food and Drug Administration approved Lecanemab and aducanumab as the first therapy with disease-modifying effects in 2023. Lecanemab has shown efficacy in several trials, with the potential to improve cognition in AD patients. In this article, we will discuss the treatment options for AD, emphasizing the newly approved monoclonal antibodies and their prospects.
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Diabetes mellitus (DM) is a complex endocrine disorder characterized by abnormally high levels of glucose, also called hyperglycemia. DM usually occurs when the body does not produce enough insulin or cannot respond to the insulin in the body. Type 1 diabetes mellitus (T1DM) or insulin-dependent diabetes is an autoimmune disease that affects around 8 million people in the world. Patients with T1DM experience an array of symptoms such as polyuria, polydipsia, and weight loss. These patients are prone to immediate life-threatening complications, including hypoglycemia and diabetic ketoacidosis. These patients are also at increased risk of ischemic heart disease, stroke, chronic kidney disease, vision loss, and even damage to nerve endings resulting in neuropathy. In this article, we will discuss type 1 diabetes mellitus and the different treatment options, focusing primarily on the Food and Drug Administration (FDA)-approved first cellular therapy for T1DM, donislecel.
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Colon carcinoma with brain metastasis is a rare presentation. This presentation is more unusual and unique when the single brain metastatic lesion has two different types of tumors. This rare phenomenon is known as a tumor-to-tumor metastasis. A meningioma usually hosts lung and breast cancers within it. However, colon carcinoma metastasis into meningiomas has rarely been reported. An 86-year-old man presented with neurological symptoms and was found to have a brain mass. The search for primary lesions was negative as the chest, abdomen, and pelvis CT scan was insignificant. When the brain lesion's pathology revealed a composite mass of adenocarcinoma and a meningioma, further investigation with a colonoscopy revealed a colonic mass as the primary metastasis lesion. This unique presentation and pathology emphasize the importance of a comprehensive investigative approach to finding the primary lesions and consideration of such a phenomenon in these lesions.
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Sickle cell disease (SCD) is a genetic hereditary blood disease that disrupts normal beta-globin production. Patients with SCD experience a broad range of symptoms ranging from anemia, pain crises, and jaundice to acute coronary syndrome and stroke. SCD has been treated with hydroxyurea since 1998. Three important pharmacotherapies have been approved by the Food and Drug Administration (FDA) in the past few years. L-Glutamine has shown efficacy in reducing vaso-occlusive pain crises and hospitalization. Crizanlizumab has also shown positive outcomes in patients with SCD. Voxelotor has been studied to be effective in improving hemolytic anemia and the quality of life in SCD patients. These drugs can be used alone or in conjunction with hydroxyurea. Trials have shown that these therapies have significant efficacy. The events of pain, hemolytic anemia, vaso-occlusive crises, and hospitalizations have been reduced by using these agents. In this editorial, we will discuss these advanced treatment options for patients with SCD.
RESUMO
The aim of this meta-analysis was to assess the effectiveness of acetazolamide as an add-on diuretic therapy in patients with heart failure. This meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A systematic literature search was independently performed by two authors using MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews to identify relevant studies assessing the use of acetazolamide in patients with heart failure. The search keywords included "acetazolamide" and "heart failure". The outcomes assessed in this meta-analysis included natriuresis (mmol/L), diuresis (Liters) and decongestion (absence of signs of volume overload) by 72 hours. Other outcomes assessed in this meta-analysis included hospitalization due to heart failure and all-cause mortality. A total of three studies included a total of 569 heart failure patients. The number of patients achieved decongestion was significantly higher in patients receiving acetazolamide compared to the patients randomized in the control group (RR: 1.34, 95% CI: 1.06-1.67). Compared to patients in the control group, mean natriuresis was significantly higher in acetazolamide patients (MD: 74.91, 95% CI: 39.85-109.97). Diuresis was significantly higher in patients receiving acetazolamide compared to the control group (MD: 0.44, 95% CI: 0.16-0.72). No significant difference was found between the two groups in terms of all-cause mortality and hospitalization due to heart failure. In conclusion, our meta-analysis suggests that acetazolamide may have beneficial impacts on heart failure patients by increasing the number of successful decongestions. Additionally, patients who were treated with acetazolamide had significantly higher natriuresis and diuresis compared to patients in the control group.
