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Review articles

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  • Fluoroscopic examination of gastrointestinal (GI) tract showing inflammatory bowel disease (IBD)

    Management of patients with inflammatory bowel disease: current and future treatments Subscription

    Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the gastrointestinal tract and affects patients’ quality of life. Treatment of IBD involves induction and maintenance of remission. Current available therapies include anti-inflammatory aminosalicylates and corticosteroids, immunosuppressive agents, antibiotics and biologic agents. Some patients are not fully responsive to conventional treatment or lose efficacy over time. Recently approved ...

  • Image 1 shows a normal spine and image 2 shows a spine affected by spondylitis

    TNFα-inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis Subscription

    Spondyloarthropathy refers to a group of articular inflammatory diseases that share common genetic, clinical and radiological features in addition to their association with human leucocyte antigen (HLA)-B27 antigen. The aim of therapeutic management of patients with spondyloarthritis is to improve quality of life, control the symptoms of articular inflammation, prevent the structural damage of joints, and preserve the functional abilities, autonomy and social participation of patients. Althou

  • Close up of a woman's hand holding hormone replacement therapy (HRT) pills

    Establishing the risk related to hormone replacement therapy and cardiovascular disease in women Subscription

    Hormone replacement therapy (HRT) has a profound impact on the cardiovascular system in postmenopausal women, achieved through its effects on metabolic risk factors for coronary heart disease (CHD) and on arterial function. Observational studies have consistently shown an association between postmenopausal HRT use and a reduced incidence of CHD. However, the largest randomised trial initially reported no overall benefit on CHD risk. Subsequent analyses and follow-up of the study have ...

  • Geneticist at the French National Institute for Health and Medical Research (Inserm) researches genetic diseases like cystic fibrosis

    Conventional therapies and emergent precision medicines for cystic fibrosis: challenges and opportunities Subscription

    30 NOV 2016 By Keith Thompson

    Around 27 years ago, the discovery of the cystic fibrosis transmembrane conductance regulator (CFTR) gene – responsible for causing cystic fibrosis (CF) – marked a significant moment in the history of the condition. Despite the early promise of this target for gene therapy, a universally successful treatment has proven elusive in the ensuing years. While clinical trials involving gene therapy continue to make progress, the ‘magic bullet’ remains some way off. Survival continues to ...

  • Coloured X-ray angiogram of a balloon catheter and stent (brown, upper centre) being placed within a coronary artery of a heart

    Role of coronary drug-eluting stents in current clinical practice Subscription

    Percutaneous coronary intervention (PCI) has continued to evolve, from its origins in balloon angioplasty and bare metal stent (BMS) implantation, to the development and application of contemporary drug-eluting stents (DESs). While first generation DESs significantly decreased risk of in-stent restenosis observed with BMSs, their use was complicated by late and very late stent thrombosis. Second generation DESs have dramatically decreased this risk and the rate of one-year stent thrombosis ...

  • Patients with cancer and cancer survivors have an increased risk of adverse cardiovascular outcomes, including left ventricular (LV) dysfunction, heart failure (HF) and acute coronary syndromes.

    Cardiovascular side effects of cancer treatments Subscription

    The cardiovascular side effects of cancer treatments remain a challenge in oncologic care. Patients with cancer and cancer survivors have an increased risk of adverse cardiovascular outcomes, including left ventricular (LV) dysfunction, heart failure (HF) and acute coronary events. The treatments most frequently associated with cardiovascular side effects include anthracyclines, monoclonal antibodies (mAbs) targeting the HER2 pathway, and small molecule tyrosine kinase inhibitors (TKIs), ...

  • Scanning electron micrograph of nasal mucosa in allergic rhinitis

    Allergic rhinitis: impact, diagnosis, treatment and management Subscription

    Allergic rhinitis results from an immunological abnormality in which atopic individuals produce immunoglobulin E (IgE) to allergens (e.g. pollen, house dust mites, animal dander and moulds). IgE activates mast cells, which respond by releasing inflammatory mediators. Histamine stimulates the early symptoms, predominately mucus production, nasal itching and sneezing. Leukotrienes and cytokines attract and activate eosinophils to cause allergic inflammation, which is primarily responsible ...

  • Statin myopathy stain showing muscle fibres in varying stages of necrosis, phagocytes and regeneration

    Statins: general safety profile and association with myopathy Subscription

    Comments (1)

    Statin therapy has demonstrated remarkable efficacy in reducing mortalities associated with cardiovascular diseases through preventing myocardial infarction and ischaemic stroke. Despite the proven benefits of statins in this context, there are growing concerns among patients and physicians on the safety of short-term and long-term use and their adverse effects, especially muscle toxicity, resulting in non-adherence and withdrawal of the treatment. Reports and publications ...

  • Hospital staff at Airedale NHS Foundation Trust use the new electronic prescribing system on the drugs round

    Impact of electronic prescribing on patient safety in hospitals: implications for the UK Subscription

    NHS hospitals in England are expected to be paperless by 2020, as set out in a comprehensive framework published by the National Information Board. The use of hospital electronic prescribing (EP) systems is therefore likely to increase rapidly in the near future. The aim of this review is to summarise the available evidence of the impact of inpatient EP on patient safety, with a focus on implications for the UK. MEDLINE and EMBASE were searched to identify systematic and narrative ...

  • Close up of kidney with renal cell carcinoma

    Mammalian target of rapamycin (mTOR) inhibitors in solid tumours Subscription

    The phosphatidylinositol-3-kinase /protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) pathway plays an important role in cell proliferation, growth, and angiogenesis. mTOR is a critical signalling protein as it serves as precursor to many pathways related to cell growth and survival. When this major pathway is dysregulated, it can cause uninhibited activation of cancer cell growth and proliferation. This commonly results in malignancies that affect the kidney, breast and ...

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