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Paz-Ibarra, José; Concepción-Zavaleta, Marcio José; Quiroz-Aldave, Juan Eduardo
doi: 10.1080/17446651.2024.2377687pmid: 38975697
Introduction The global incidence of thyroid cancer (TC) has increased in the last decades. While improvements in diagnosis may contribute, overdiagnosis is also a possibility. This review focuses on the epidemiology, risk factors, and immune microenvironment associated with differentiated TC (DTC). Areas covered A search was conducted in Scielo, Scopus, and EMBASE databases, involving 72 articles. TC is the most common endocrine neoplasm, with DTC form being predominant. Its incidence has globally risen, particularly among women aged over 45. Endogenous risk factors for DTC include genetic disorders, race, age, female gender, obesity, and type 2 diabetes mellitus. Environmental risks involve ionizing radiation, whether through therapeutic treatment or environmental contamination from nuclear accidents, iodine deficiency, endocrine disruptors, residence in volcanic areas, environmental pollution, and stress. The use of anti-obesity medications remains controversial. The tumor’s immune microenvironment is the histological space where tumor cells interact with host cells, crucial for understanding aggressiveness. Immunotherapy emerges as a promising intervention. Expert opinion Recent advances in DTC management offer transformative potential, requiring collaborative efforts for implementation. Emerging areas like precision medicine, molecular profiling, and immunotherapy present exciting prospects for future exploration, shaping the next era of diagnostic and therapeutic strategies in thyroid cancer research.
Taylor-Miller, Tashunka; Savarirayan, Ravi
doi: 10.1080/17446651.2024.2390416pmid: 39132812
Introduction Achondroplasia is a heritable disorder of the skeleton that affects approximately 300,000 individuals worldwide. Until recently, treatment for this condition has been purely symptomatic. Efficacious treatment options for children are now approved or are in clinical trials. Areas covered This review discusses key advances in the therapeutic management of children with achondroplasia, including vosoritide, the first approved drug, and other emerging precision therapies. These include navepegritide, a long-acting form of C-type natriuretic peptide, and infigratinib, a tyrosine kinase receptor inhibitor, summarizing trial outcomes to date. Expert opinion The advent of the first approved precision therapy for achondroplasia in vosoritide has been a paradigm shifting advance for children affected by this condition. In addition to changing their natural growth history, it is hoped that it will decrease their medical complications and enhance functionality. These new treatment options highlight the importance of prompt prenatal identification and subsequent testing of a suspected fetus with achondroplasia and counseling of families. It is hoped that, in the near future, families will have the option to consider a range of effective targeted therapies that best suit their child with achondroplasia, starting from birth should they choose.
Rabbani, Syed Arman; El-Tanani, Mohamed; Matalka, Ismail I.; Rangraze, Imran Rashid; Aljabali, Alaa A. A.; Khan, Mohammad Ahmed; Tambuwala, Murtaza M.
doi: 10.1080/17446651.2024.2395540pmid: 39194153
Introduction Incretin-based therapies have emerged as effective treatments for type 2 diabetes (T2D) and obesity. However, not all patients achieve optimal outcomes with existing treatments, highlighting the need for more effective solutions. Areas covered We present a comprehensive evaluation of Tirzepatide (TZP), a novel dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonist, for managing obesity and T2D. We conducted a systematic search of Cochrane, PubMed, Scopus, and Web of Science databases from inception to April 2024. The focus of the review is on the development and therapeutic potential of TZP, with detailed exploration on pharmacodynamics, pharmacokinetics, clinical efficacy, and safety. Furthermore, it reviews TZP’s impacts on glycemic control, weight management, and its potential cardiovascular (CV) benefits. Expert opinion TZP represents a significant advancement in the dual-targeted approach to treating T2D and obesity. Its unique mechanism of action offers superior efficacy in reducing glycemic levels and body weight compared to existing therapies. New data suggesting improvements in CV outcomes indicate that TZP could set a new standard in the treatment paradigm. While long-term data on efficacy and safety are still forthcoming, current evidence positions TZP as a promising option for patients who have not reached their therapeutic goals with existing treatments.
Ohno, Takayuki; Tsujino, Daisuke; Nishimura, Rimei
doi: 10.1080/17446651.2024.2400487pmid: 39235079
Objective Time in Tight Range (TITR), defined as the percentage of time within the glucose range of 70 to 140 mg/dL, is anticipated to be challenging to maintain without causing hypoglycemia, especially in individuals with type 1 diabetes (T1D). This study aimed to investigate the TITR target value in individuals with T1D on multiple daily injections (MDI). Methods The study included 101 individuals with T1D on MDI aged 15 to 75 who were hospitalized at Jikei University School of Medicine from September 2006 to November 2013 to conduct Continuous Glucose Monitoring (CGM). The cutoff values of TITR for predicting the attainment of GMI < 7.0%, and TBR < 4% were determined using Receiver Operating Characteristic (ROC) curves. Results The TITR cutoff value was calculated to be 41% (sensitivity 81%, specificity 88%) and 40% (54%,72%) for predicting GMI < 7.0% and TBR < 4%. Conclusions In individuals with T1D on MDI without devices capable of preventing hypoglycemia, it is recommended to target TITR at 40% to address the risk of increased hypoglycemia sufficiently.
Alkattan, Abdullah; Al-Zeer, Abdullah; Alsaawi, Fahad; Alyahya, Alanoud; Alnasser, Raghad; Alsarhan, Raoom; Almusawi, Mona; Alabdulaali, Deemah; Mahmoud, Nagla; Al-Jafar, Rami; Aldayel, Faisal; Hassanein, Mustafa; Haji, Alhan; Alsheikh, Abdulrahman; Alfaifi, Amal; Elkagam, Elfadil; Alfridi, Ahmed; Alfaleh, Amjad; Alabdulkareem, Khaled;
Showing 1 to 6 of 6 Articles
doi: 10.1080/17446651.2024.2400706pmid: 39245968
Background According to previous reports, very high percentages of individuals in Saudi Arabia are undiagnosed for type 2 diabetes mellitus (T2DM). Despite conducting several screening and awareness campaigns, these efforts lacked full accessibility and consumed extensive human and material resources. Thus, developing machine learning (ML) models could enhance the population-based screening process. The study aims to compare a newly developed ML model’s outcomes with the validated American Diabetes Association’s (ADA) risk assessment regarding predicting people with high risk for T2DM. Research design and methods Patients’ age, gender, and risk factors that were obtained from the National Health Information Center’s dataset were used to build and train the ML model. To evaluate the developed ML model, an external validation study was conducted in three primary health care centers. A random sample (N = 3400) was selected from the non-diabetic individuals. Results The results showed the plotted data of sensitivity/100-specificity represented in the Receiver Operating Characteristic (ROC) curve with an AROC value of 0.803, 95% CI: 0.779–0.826. Conclusions The current study reveals a new ML model proposed for population-level classification that can be an adequate tool for identifying those at high risk of T2DM or who already have T2DM but have not been diagnosed.