The KMT2A (formerly MLL) encodes the histone lysine-specific N-methyltransferase 2A and is mapped on chromosome 11q23. KMT2A is a frequent target for recurrent translocations in acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), or mixed lineage (biphenotypic) leukemia (MLL). Over 90 KMT2A fusion partners have been identified until now, including the most recurring ones—AFF1, MLLT1, and MLLT3—which encode proteins regulating epigenetic mechanisms. The presence of distinct KMT2A rearrangements is an independent dismal prognostic factor, while very few KMT2A rearrangements display either a good or intermediate outcome. KMT2A-rearranged (KMT2A-r) ALL affects more than 70% of new ALL diagnoses in infants (<1 year of age), 5–6% of pediatric cases, and 15% of adult cases. KMT2A-rearranged (KMT2A-r) ALL is characterized by hyperleukocytosis, a relatively high incidence of central nervous system (CNS) involvement, an aggressive course with early relapse, and early relapses resulting in poor prognosis. The exact pathways of fusions and the effects on the final phenotypic activity of the disease are still subjects of much research. Future trials could consider the inclusion of targeted immunotherapeutic agents and prioritize the identification of prognostic factors, allowing for the less intensive treatment of some infants with KMT2A ALL. The aim of this review is to summarize our knowledge and present current insight into the mechanisms of KMT2A-r ALL, portray their characteristics, discuss the clinical outcome along with risk stratification, and present novel therapeutic strategies.
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is one of the leading causes of cancer-related deaths worldwide. Despite advances in medicine, it is still a cancer with a very poor prognosis. Both imaging and liver biopsy still have important limitations, especially in very small nodules and those which show atypical imaging features. In recent years, liquid biopsy and molecular analysis of tumor breakdown products have become an attractive source of new biomarkers. Patients with liver and biliary malignancies, including hepatocellular carcinoma (HCC), may greatly benefit from ctDNA testing. These patients are often diagnosed at an advanced stage of the disease, and relapses are common. Molecular analysis may indicate the best cancer treatment tailored to particular patients with specific tumor DNA mutations. Liquid biopsy is a minimally invasive technique that facilitates the early detection of cancer. This review summarizes the knowledge of ctDNA in liquid biopsy as an indicator for early diagnosis and monitoring of hepatocellular cancer.
So far, the rate of HIV-positive people who do not know their sero-status is about 14% and the percentage is higher among transgender women (TGW). They represent one of the most vulnerable groups to infection. HIV self-testing (HIVST) may be a way to reduce transmission of the virus. The aim of this analysis and in-depth review was to collect available data on factors that may influence the use and dissemination of HIVST among TGW. This review was conducted in accordance with PRISMA guidelines for systematic reviews and meta-analyses. All data from 48 papers were used. From the available literature, HIVST is a convenient and preferred method of testing due to its high confidentiality and possibility of being performed at home. However, there are barriers that limit its use, including marginalization of transgender people, stigma by medical personnel, lack of acceptance of sexual partners, and even cultural standards. Therefore, there is a need for activities that promote and inform on the possibility of using HIVST as well as enable easier access to it.
Gastrointestinal cancers are characterized by high incidence and mortality. However, there are well-established methods of screening. The endoscopy exam provides the macroscopical image and enables harvesting the tissue samples for further histopathological diagnosis. The efficiency of endoscopies relies not only on proper patient preparation, but also on the skills of the personnel conducting the exam. In recent years, a number of reports concerning the application of artificial intelligence (AI) in medicine have arisen. Numerous studies aimed to assess the utility of deep learning/ neural network systems supporting endoscopies. In this review, we summarized the most recent reports and randomized clinical trials regarding the application of AI in screening and surveillance of gastrointestinal cancers among patients suffering from esophageal, gastric, and colorectal cancer, along with the advantages, limitations, and controversies of those novel solutions.
25 May 2022 in Journal of Education, Health and Sport
Background: The term CAM denotes complementary and alternative medicine. However, CAM is practiced by individuals without academic medical education and formal eligibility for treating people. The extent of interest in CAM is considerable. The WHO global report on traditional and complementary medicine has demonstrated that 87% of all WHO Member States legally recognise individual forms of CAM, and 100 Member States have national policies regarding such practices. In Poland, performing medical activities without appropriate qualifications is prohibited. Material and Methods: Diagnostic survey distributed as Google Forms was used as the basic research method with the research technique of a questionnaire. The questionnaire starting with a metrics part consisted of several questions regarding popularity and tendency of CAM, causes of CAM popularity, approach to those types of practices and patients as well as role of CAM during the pandemic. Sixty-one responses were obtained from physicians of different age, experience and speciality. Results: Ninety-five percent (95%) of doctors believe that alternative medicine can be dangerous; 67.2% think that the phenomenon of alternative medicine should be combated; almost half of the physicians surveyed believe that there is a fundamental contradiction between evidence-based medicine (EBM) and alternative medicine. Furthermore, according to 48% of respondents, physicians in Poland should be able to recommend and combine methods of traditional and alternative medicine. Conclusion: Doctors point to the increasing popularity of CAM among patients in Poland, the consequences of which cannot be determined because there is still a lack of research on the safety of alternative methods. The most frequently cited reasons for interest in CAM suggest that there is a need for a better tailored biomedical approach to individual patient needs.
26 July 2021 in Journal of Education, Health and Sport
BACKGROUND: The COVID-19 pandemic brought changes to daily life of many people. One of those affected by the global pandemic arena was work life. One of the results is burnout due to new challenges and stress associated with them. The most exposed occupational group were healthcare workers as the frontline in the fight against the virus, but not only this group could experience burnout due to the pandemic. AIM OF THE STUDY: The aim of this study was to review the most recent available literature on burnout associated with COVID-19. PubMed, SCOPUS, and Google Scholar databases were reviewed. The Phrase "burnout and covid" was used to search the database. Search criteria were: all open access, 2020 and 2021, psychology and English. After Screening titles and abstracts 21 articles were analyzed in detail.RESULTS: Many studies have shown that healthcare workers experienced burnout. The most vulnerable group were young, female nurses working with COVID-19 patients. Burnout was also observed among parents, who started working remotely from home or who had to commute to their workplace despite the pandemic. Remote schooling also contributed to burnout among students and teachers.SUMMARY AND CONCLUSIONS: To reduce the possibility of experiencing burnout there are several actions that could be taken. First of all a positive attitude and task oriented actions are helpful in coping in new, stressful situations. Other solutions are social support and psychotherapy.