Targeted Therapies for Hepatocellular Carcinoma Treatment: A New Era Ahead-A Systematic Review.

Hepatocellular carcinoma (HCC) remains one of the most common malignancies and the third cause of cancer-related death worldwide, with surgery being the best prognostic tool. Among the well-known causative factors of HCC are chronic liver virus infections, chronic virus hepatitis B (HBV) and chronic hepatitis virus C (HCV), aflatoxins, tobacco consumption, and non-alcoholic liver disease (NAFLD). There is a need for the development of efficient molecular markers and alternative therapeutic targets of great significance. In this review, we describe the general characteristics of HCC and present a variety of targeted therapies that resulted in progress in HCC therapy.

Liver Transplantation and Budd-Chiari Syndrome: When the Cause Becomes the Solution.

Budd-Chiari syndrome consists a rare medical entity which has an estimated incidence of 0.1 to 10 people per million every year. It is defined by the obstruction of the flow in the inferior vena cava or the hepatic veins. Various classifications have been proposed. So, it can be acute or chronic and primary or secondary. Iatrogenic, a subtype of secondary Budd-Chiari syndrome, is caused by various medical interventions, including liver transplantation. On the other hand, liver transplantation is the ultimate therapeutic management of Budd-Chiari syndrome. Finally, a medical paradox and a vicious circle has been created. Liver transplantation can potentially be both the cause and treatment of Budd-Chiari syndrome. Budd-Chiari syndrome is simultaneously the cause and complication of liver transplantation. Our aim is to describe this double role of liver transplantation in Budd-Chiari syndrome and to acknowledge that a high degree of clinical suspicion is necessary for the proper recognition and management of this life-threatening condition.

The Role of SNHG15 in the Pathogenesis of Hepatocellular Carcinoma.

Long non-coding RNAs (lncRNAs) are transcripts of more than 200 nucleotides which cannot be translated into proteins. Small nucleolar RNA host gene 15 (SNHG15) is a lncRNA whose dysregulation has been found to have an important impact on carcinogenesis and affect the prognosis of cancer patients in various cancer types. Hepatocellular carcinoma (HCC) is one of the most common cancers with a poor long-term prognosis, while the best prognostic factor of the disease is its early diagnosis and surgery. Consequently, the investigation of the mechanisms of hepatocarcinogenesis, as well as the discovery of efficient molecular markers and therapeutic targets are of great significance. An extensive literature search was performed in MEDLINE in order to identify clinical studies that tried to reveal the role of SNHG15 in HCC. We used keywords such as 'HCC', 'hepatocellular carcinoma', 'SNHG15' and 'clinical study'. Finally, we included four studies written in English, published during the period 2016-2021. It was revealed that SNHG15 is related to the appearance of HCC via different routes and its over-expression affects the overall survival of the patients. More assays are required in order to clarify the potential role of SNHG15 as a prognostic tool and therapeutic target in HCC.

Targeting the Endocannabinoid System: From the Need for New Therapies to the Development of a Promising Strategy. What About Pancreatic Cancer?

Pancreatic cancer is one of the most fatal malignancies, and therefore, new strategies, which aim at the improvement of the prognosis of this lethal disease, are needed. Many clinical trials have failed to improve overall survival. Nowadays, research is focused on advances provided by novel potential targets to efficiently enhance life expectancy. Cannabinoids, the active components of Cannabis sativa L., and their derivatives, have been reported as palliative adjuvants to conventional chemotherapeutic regimens. Cannabinoid effects are known to be mediated through the activation of cannabinoid receptors. To date, two cannabinoid receptors, cannabinoid receptor 1 and 2, have been cloned and identified from mammalian tissues. Cannabinoids exert a remarkable antitumoral effect on pancreatic cancer cells, due to their ability to selectively induce apoptosis of these cells. This review strengthens the perception that cannabinoid receptors might be useful in clinical testing to prognose and treat pancreatic cancer. Many studies have tried to describe the mechanism of cell death induced by cannabinoids. The aim of this review is to discuss the effects of cannabinoid receptors in pancreatic cancer in order to provide a brief insight into cannabinoids and their receptors as pancreatic cancer biomarkers and in therapeutic strategies.

Polycystic Horseshoe Kidney: A Rare Coexistence as a Challenge for the Surgeons. Case Report.

Autosomal dominant polycystic kidney disease (ADPKD) with concomitant horseshoe kidney is an extremely rare entity. In this case, we report a 45-year-old male patient with ADPKD and a horseshoe kidney who demonstrated hypertension, urological complications, and discomfort symptoms such as pain, breathing difficulties, and abdominal meteorism. After preoperative assessment and planning, the patient underwent nephrectomy. Bilateral nephrectomy without dividing the isthmus was performed successfully. The isthmus, which had complicated vasculature and was full of cysts, remained intact, avoiding severe bleeding and infection. The postoperative course was uneventful. Keeping the isthmus intact in such cases is a challenge for the surgeon. The rarity of polycystic horseshoe kidney in combination with the altered abdominal anatomy requires the proper preoperative strategy in order to avoid intraoperative complications.

Functional Scaphoid Pseudarthrosis. Two Cases with Long-term Follow-up after Closed Wedge Osteotomy of the Distal Radius.

Introduction: Closed wedge osteotomy of the distal radius represents a treatment option for the advanced scaphoid pseudarthrosis. Few authors have reported good results with many of the cases achieving union of the scaphoid. The aim of this study is to inform about the functional long-term outcome of two patients in whom bone union was not achieved after this procedure. Case Report: In this article, we present two patients, one with 5 and one with 40 years of follow-up who were treated with closed wedge osteotomy of the distal radius due to advanced scaphoid nonunion. We evaluated the functional outcome which was excellent and in addition radial translocation of the carpus was found as it was compared the anteroposterior radiographs before surgery and at the end of the follow-up period. Conclusion: Closed wedge osteotomy of the radius is an extra articular procedure that can cause radial translocation of the wrist and change its biomechanics, while the functional outcome does not depend on whether fracture healing is achieved.