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Primary sclerosing cholangitis (PSC) is an inflammatory, cholestatic and progressively fibrotic liver disease devoid of effective medical intervention. PBC is a presumed immune-mediated liver disease of middle-aged women associated with significant morbidity and mortality. People living with PBC are frequently symptomatic, experiencing a quality-of-life burden dominated by fatigue, itch, abdominal pain, and sicca complex. Many drugs have been studied for treatment, including agents with choleretic and immunosuppressive properties. Future PBC licensed therapy will likely include peroxisome proliferator activated receptor (PPAR) pathway agonists, including specific PPAR-delta agonism (seladelpar), as well as elafibrinor and saroglitazar (both with broader PPAR agonism). Effective therapy reduces the need for transplantation and improves life expectancy.

Introduction Migraine is a heavily debilitating disease that ranks second place in Global Burden Disease. It is estimated that around 1 billion of people suffer from it. It also has a significant negative impact on health-related quality of life (HRQoL) of patients and can affect their social, occupational, academic and familial life. Thus, it is crucial that all of the patients receive an effective treatment. Objectives This article aims to review the most recent advances in treatment of migraine. Methods A Literature review of articles published in Pubmed between 2000 and 2024 using the following words ‘migraine’, ‘treatment advances’, ‘CGRP receptor antagonists’, ‘serotonin receptor agonists’, ‘lasmiditan’, ‘zavegepant’, ‘rimegepant’. Results Literature search provides several concepts of advances in migraine treatment. Apart from behavioral treatment, new drugs targeting calcitonin gene related receptors (CGRP) and serotonin receptors agonists are emerging. Conclusion Migraine is a debilitating disease which significantly reduces health related quality of life in patients. New drugs targeting calcitonin gene related receptors (CGRP) and serotonin receptors agonists give a chance for more effective and tailored treatment.

Geriatric horses have a high prevalence of dental disease, which is a culmination of age-related dental changes and dental disease throughout the life of the horse that may have long-term consequences. Wear abnormalities, diastemata with periodontal disease, pulpitis and endodontic disease, infundibular caries, and equine odontoclastic tooth resorption and hypercementosis become more prevalent with age. Recognition of age-related dental disease at an early stage can help to treatand possibly preserve teeth for longer. With a natural decrease in masticatory efficiency, it is even more important to preserve teeth where possible and prevent any painful dental disease. Regular routine dental examination and maintenance will help to prevent many dental conditions such as wear disorders and possibly secondary diastemata. Successful treatment and management of most dental diseases are possible even in older patients and will ensure that we are able to maintain a high standard of welfare as horses age. [ABSTRACT FROM AUTHOR]

Radiotherapy plays an essential role in the treatment of breast cancer (BC). Recent advances in treatment technology and radiobiological knowledge have a major impact in BC patients with locoregional disease as the majority are now long-term survivors. Over the last three decades, intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy (VMAT) and deep inspiration breath-hold (DIBH) techniques, together with the increasing adoption of moderately hypofractionated and ultra-hypofractionated treatment schedules as well as the possibility to offer partial breast radiotherapy to a well-defined patient subset have significantly changed radiotherapy for BC patients. As dose-volume constraints (DVCs) have to be adapted to these new treatment paradigms we have reviewed available evidence-based data concerning dose-constraints for the main organs at risk (OARs) that apply to the treatment of whole breast/chest wall radiotherapy, whole breast/chest wall radiotherapy including regional nodal irradiation (RNI) and partial breast irradiation (PBI), for the most relevant fractionation schedules that have been introduced recently. This narrative review provides a comprehensive summary that may help to harmonize treatment planning strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Human immunodeficiency virus (HIV) and tuberculosis (TB) are two of the most pressing global health issues, each contributing significantly to morbidity and mortality worldwide. This review provides a comprehensive analysis of HIV-associated TB (HIV-TB), focusing on the clinical challenges and advancements in its management. HIV-positive individuals are at a heightened risk of developing active TB due to the immunosuppressive effects of the virus, which complicates both diagnosis and treatment. The interplay between these two diseases exacerbates health outcomes, presenting unique challenges related to drug interactions, adherence to treatment regimens, and management of adverse effects. This review explores the current diagnostic approaches, including advances in testing technologies and screening strategies, and examines treatment protocols, highlighting the integration of antiretroviral therapy with TB treatment. Special considerations for managing HIV-TB in various populations, such as children, pregnant women, and the elderly, are discussed. Additionally, the review addresses public health strategies for prevention and the impact of socio-economic and healthcare system factors on disease management. Finally, it highlights recent research innovations and future directions aimed at improving outcomes for individuals with HIV-TB. By synthesizing the latest evidence and clinical practices, this review aims to enhance understanding and guide effective management of this critical co-infection, ultimately contributing to reduced global burden and improved patient care., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Patel et al.)

Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized by obsessions (recurrent, intrusive and unwanted thoughts) and compulsions (excessive, repetitive and ritualistic behaviors or mental acts). OCD is heterogeneous in its clinical presentation and not all patients respond to first-line treatments. Several neurocircuit models of OCD have been proposed with the aim of providing a better understanding of the neural and cognitive mechanisms involved in the disorder. These models use advances in neuroscience and findings from neuropsychological and neuroimaging studies to suggest links between clinical profiles that reflect the symptoms and experiences of patients and dysfunctions in specific neurocircuits. Several models propose that treatments for OCD could be improved if directed to specific neurocircuit dysfunctions, thereby restoring efficient neurocognitive function and ameliorating the symptomatology of each associated clinical profile. Yet, there are several important limitations to neurocircuit models of OCD. The purpose of the current review is to highlight some of these limitations, including issues related to the complexity of brain and cognitive function, the clinical presentation and course of OCD, etiological factors, and treatment methods proposed by the models. We also provide suggestions for future research to advance neurocircuit models of OCD and facilitate translation to clinical application. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD) is a common psychiatric condition classically characterized by obsessions (recurrent, intrusive and unwanted thoughts) and compulsions (excessive, repetitive and ritualistic behaviors or mental acts). OCD is heterogeneous in its clinical presentation and not all patients respond to first-line treatments. Several neurocircuit models of OCD have been proposed with the aim of providing a better understanding of the neural and cognitive mechanisms involved in the disorder. These models use advances in neuroscience and findings from neuropsychological and neuroimaging studies to suggest links between clinical profiles that reflect the symptoms and experiences of patients and dysfunctions in specific neurocircuits. Several models propose that treatments for OCD could be improved if directed to specific neurocircuit dysfunctions, thereby restoring efficient neurocognitive function and ameliorating the symptomatology of each associated clinical profile. Yet, there are several important limitations to neurocircuit models of OCD. The purpose of the current review is to highlight some of these limitations, including issues related to the complexity of brain and cognitive function, the clinical presentation and course of OCD, etiological factors, and treatment methods proposed by the models. We also provide suggestions for future research to advance neurocircuit models of OCD and facilitate translation to clinical application.

Vitamins are the essential dietary components that are required in trace amounts by our body for the proper functioning of its biochemical processes and to prevent the deficiency diseases. The case of an infant having epileptic seizures at birth is discussed, which was found to be pyridoxine (vitamin B6) - dependent. It has been discovered through recent researches that vitamin K is involved in the immunology, atherosclerosis, inflammation and bone mineralization. Vitamin C is found to act as an anti-tumor agent when used intravenously in high doses. Recent researches have led us to understand that vitamins have a broader spectrum of functions than they are anticipated to have in our body and can be used to treat much more diseases when used alone, in combination or via different routes or in different concentrations or doses. [ABSTRACT FROM AUTHOR]

Objective: Treatment options for non‐small‐cell lung cancer (NSCLC) have been evolving. The goal of our study was to evaluate whether novel therapeutics are used in the elderly population and improve outcomes to a similar extent as in young patients. Methods: We enrolled patients registered in the Cancer Registry of Eastern Switzerland and grouped them into four cohorts: Elderly patients aged ≥70 years diagnosed 2005–2007 and 2015–2016 (elderly cohorts 1,2) were compared to cohorts of patients < 70 years diagnosed during the same time periods (young cohorts 1,2). Results: 499 individuals were analysed. Median cancer‐specific survival in the elderly cohorts 1 and 2 was 3.9 months and 6.3 months, respectively, and 8.0 and 12.7 months in the young cohorts 1 and 2. 12‐month survival significantly improved over ten years only in younger patients (35.6% and 54.9%), however not in the elderly cohorts (20% vs. 35%). Proportion of patients receiving any line of systemic treatment remained lower in the elderly cohorts (53% vs. 78%). Conclusion: Despite the increase in median cancer‐specific survival in both cohorts, a significant and clinically meaningful improvement of 12‐month cancer‐specific survival was only seen in young patients. The adoption of novel treatment approaches is lagging behind in the elderly population. [ABSTRACT FROM AUTHOR]

Leptomeningeal metastasis (LM) is a serious and often fatal complication in patients with advanced lung cancer, resulting in significant neurological deficits, decreased quality of life, and a poor prognosis. This article summarizes current research advances in treating lung cancer with meningeal metastases, discusses clinical challenges, and explores treatment strategies. Through an extensive review of relevant clinical trial reports and screening of recent conference abstracts, we collected clinical data on treating patients with lung cancer with meningeal metastases to provide an overview of the current research progress. Exciting progress has been made by focusing on specific mutations within lung cancer, including the use of EGFR tyrosine kinase inhibitors or inhibitors for anaplastic lymphoma kinase gene rearrangement, such as osimertinib, alectinib, and lorlatinib. These targeted therapies have shown impressive results in penetrating the central nervous system (CNS). Regarding whole-brain radiotherapy, there is currently some controversy among investigators regarding its effect on survival. Additionally, immune checkpoint inhibitors (ICIs) have demonstrated reliable clinical benefits due to their ability to retain anticancer activity in CNS metastases. Moreover, combination therapy shows promise in providing further treatment possibilities. Considerable progress has been made in the clinical research of lung cancer with LM. However, the sample size of prospective clinical trials investigating LM for lung cancer is still limited, with most reports being retrospective. Developing more effective management protocols for metastatic LM in lung cancer remains an ongoing challenge for the future., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

To investigate whether any reduction in all-cause mortality and cardiovascular disease morbidity was found over the decade in type 2 diabetes on real-world practice. A prospective observational study was performed by following two independent cohorts recruited in 2004 (n = 3286, Cohort 1) and 2014 (n = 3919, Cohort 2). The primary outcome was a composite of onset of cardiovascular disease and death. Cox proportional hazards analysis was used to explore any difference between Cohort 2 and Cohort 1 for the composite endpoints and cardiovascular disease after adjustment for covariates and accumulation of five risks (smoking, HbA1c, blood pressure, lipids, and albuminuria) outside target ranges. During the 8-year follow-up, 391 (11.9%) and 270 (6.9%) primary outcomes, and 270 (8.2%) and 161 (4.1%) cardiovascular diseases occurred in Cohort 1 and Cohort 2, respectively. Cohort 2 (vs. Cohort 1) exhibited a significant risk reduction for composite endpoints (HR 0.73, 95% CI 0.62 to 0.86) and cardiovascular disease (HR 0.64, 95% CI 0.52 to 0.79), and similarly exhibited a significant reduction independent of the accumulation of the five risks. The significant reduction of Cohort 2 for cardiovascular disease independent of the baseline covariates suggests an integrated effect delivered by the recent treatment advances. [ABSTRACT FROM AUTHOR]

Late onset depression has recently emerged as a serious mental health issue in the geriatric population with significant public health implications. It is often challenging to diagnose and treat this entity. Various theories have been postulated to elucidate the etiology of late onset depression, but a unifying hypothesis is lacking. Although the vascular hypothesis is most researched; a complex interaction of multiple vulnerability factors is the current focus of attention. Numerous psychosocial variables have been implicated to play a significant role in predicting the onset and severity of late-life depression. Phenomenological differences have been delineated from depression occurring at a younger age, but the findings are equivocal. A better understanding of the natural trajectory of depression in the elderly is required for early diagnosis and effective treatment. This review attempts to summarize the current status of evidence regarding epidemiology, etiology, clinical features, and treatment options available for late-onset depression.

Antiretroviral therapy (ART) is a chronic suppressive treatment that provides lifelong treatment effectively for patients with HIV, improving the quality of life for patients. Although the overall trend of new infections is declining, the number of new HIV infections per year and the number of deaths related AIDS is still very large > remaining one of the world's biggest public health challenges. In the field of epidemiology, HIV/AIDS distributed in poor areas with limited medical means such as Africa,and men who have sex with men (MSM), sex workers and people who inject drugs (PWID) become the main susceptible population； In the field of prevention, prevention of mother-to-child transmission (PMTCT) services，treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP) have achieved initial success, but the coverage is still limited； In the field of treatment, the extent of HIV resistance in multiple countries increases to more than 10%, and the cure of HIV/AIDS research and vaccine development are currently in animal or cellular experiments. Over the past decade, China has established several measures to prevent the HIV epidemic further,and improve the quality of life of people living with HIV/AIDS patients. At the same time, China is also facing the following challenges： the targeted prevention program» susceptible groups increased (such as MSM, PWID and youth), long-term care of patients with HIV/AIDS, the coverage of PMTCT services，eliminate discrimination process»etc. Therefore, the purpose of this article is to review the epidemic status and control strategies of HIV/AIDS in China and the whole world in recent years. [ABSTRACT FROM AUTHOR]

During the past 50 years, there has been a remarkable transformation in the management of lung and esophageal cancers. Improved methods of diagnosis, better staging and patient selection for surgery, the advent of minimally invasive approaches to resection, decreasing operative mortality, greater insights into tumor biology, and the development of effective multimodality therapies and precision medicine have contributed to this transformation. Progress has been most notable in lung cancer., (© 2022 Wiley Periodicals LLC.)

Recent advances in the treatment of multiple myeloma have resulted in improved response rates and overall survival in patients with multiple myeloma. These advances are largely due to thalidomide-, lenalidomide-, and bortezomib-based combinations that have improved response rates, not only in patients with untreated disease, but also in those with relapsed and/or refractory myeloma, in some cases producing response rates up to 85%. Eventually, however, nearly all patients relapse, emphasizing a continuing role for the introduction of investigational agents that overcome drug resistance. This article will review the current role for thalidomide, lenalidomide, and bortezomib-based combinations, as well as some preliminary findings for promising investigational agents currently in clinical trials for patients with relapsed and/or refractory disease. [ABSTRACT FROM AUTHOR]

Exciting changes have been made in the management of testicular germ cell cancers over the past 30 years. Today, more than 80% of men who present with metastatic disease are cured compared with about 15% in the early 1970s. This means that there are a large number of survivors and many of them have willingly provided information that can be used in shaping the management of other malignancies. The paper aims to summarize the current management of testicular germ cell cancers comparing the situation in the pre-platinum era with that today and to consider current and future developments in the management of this disease. [ABSTRACT FROM AUTHOR]

Abstract Despite the appearance of new treatment, dietary approach remains the mainstay of PKU therapy. The nutritional management has become complex to optimize PKU patients' growth, development and diet compliance. This paper review critically new advances and challenges that have recently focused attention on potential relevant of LCPUFA supplementation, progress in protein substitutes and new protein sources, large neutral amino acids and sapropterin. Given the functional effects, DHA is conditionally essential substrates that should be supplied with PKU diet in infancy but even beyond. An European Commission Programme is going on to establish quantitative DHA requirements in this population. Improvements in the palatability, presentation, convenience and nutritional composition of protein substitutes have helped to improve long-term compliance with PKU diet, although it can be expected for further improvement in this area. Glycomacropeptide, a new protein source, may help to support dietary compliance of PKU subject but further studies are needed to evaluate this metabolic and nutritional issues. The PKU diet is difficult to maintain in adolescence and adult life. Treatment with large neutral amino acids or sapropterin in selected cases can be helpful. However, more studies are necessary to investigate the potential role, dose, and composition of large neutral amino acids in PKU treatment and to show long-term efficacy and tolerance. Ideally treatment with sapropterin would lead to acceptable blood Phe control without dietary treatment but this is uncommon and sapropterin will usually be given in combination with dietary treatment, but clinical protocol evaluating adjustment of PKU diet and sapropterin dosage are needed. In conclusion PKU diet and the new existing treatments, that need to be optimized, may be a complete and combined strategy possibly positive impacting on the psychological, social, and neurocognitive life of PKU patients.

The article discusses Cystic fibrosis (CF), an autosomal recessive monogenetic condition effecting 1 in 3000 live births in individuals of northern European descent and there are about 70 000 individuals with CF worldwide. Topics include access to modulator therapy from birth, effects of mutations in the gene coding for the CF transmembrane conductance regulator (CFTR), and developments in the treatment for the condition.

Pancreatic cancer is a leading cause of cancer mortality and the incidence of this disease is expected to continue increasing. While patients with pancreatic cancer have traditionally faced a dismal prognosis, over the past several years various advances in diagnosis and treatment have begun to positively impact this disease. Identification of effective combinations of existing chemotherapeutic agents, such as the FOLFIRINOX and the gemcitabine + nab-paclitaxel regimen, has improved survival for selected patients although concerns regarding their toxicity profiles remain. A better understanding of pancreatic carcinogenesis has identified several pre-malignant precursor lesions, such as pancreatic intraepithelial neoplasias, intraductal papillary mucinous neoplasms, and cystic neoplasms. Imaging technology has also evolved dramatically so as to allow early detection of these lesions and thereby facilitate earlier management. Surgery remains a cornerstone of treatment for patients with resectable pancreatic tumors, and advances in surgical technique have allowed patients to undergo resection with decreasing perioperative morbidity and mortality. Surgery has also become feasible in selected patients with borderline resectable tumors as a result of neoadjuvant therapy. Furthermore, pancreatectomy involving vascular reconstruction and pancreatectomy with minimally invasive techniques have demonstrated safety without significantly compromising oncologic outcomes. Lastly, a deeper understanding of molecular aberrations contributing to the development of pancreatic cancer shows promise for future development of more targeted and safe therapeutic agents.