Thelansis

 

  Erosive esophagitis (EE) is a common symptom of gastroesophageal reflux disease (GERD) (GERD). Without continued treatment, most patients with healed EE (approximately 80% – 90%) will relapse within 6 – 12 months. The major esophageal complications of EE include ulcer bleeding and strictures. Although death from EE is uncommon, these complications are associated with significant morbidity and mortality rates. Although there is some overlap in acid exposure among esophagitis grades, the severity of EE is related to the duration of esophageal acid exposure. Because of their ability to control esophageal acid exposure, symptoms, and esophagitis, acid-suppressive therapy with proton pump inhibitors (PPIs) is recommended as first-line therapy for GERD and EE. Esomeprazole is the S-enantiomer of the racemic PPI omeprazole, with which it shares the exact pharmacodynamic mechanism of action. Both of these PPIs block the proton pump H+/K+ adenosine triphosphatase.   The competiti...

  Congenital diarrheal disorders (CDDs) are a group of inherited enteropathies that typically manifest themselves in childhood. Despite their different outcomes, most CDDs have a similar clinical presentation. In most cases, appropriate therapy must be started immediately to prevent dehydration and long-term, and sometimes life-threatening, complications. Milder forms of CDDs, with a less severe clinical picture that remain undiagnosed until later ages, have been described. The less severe outcome may be due to a milder effect of disease gene mutations. Types of CDDs are more common in some ethnic groups due to consanguineous marriages or founder effects such as congenital lactase deficiency (CLD), lysinuric protein intolerance, or sucrose isomaltase deficiency. IL10RA was the most commonly detected pathogenic variant. Congenital chloride diarrhea and Schwachman–Diamond syndrome were leading causes of CDDs with 68% and 12%, respectively, among the neonatal patients.   Th...

  Avascular necrosis (AVN) of the femoral head is caused by the interruption of blood supply to the bone of the proximal femur. The loss of blood supply can result from both traumatic and non-traumatic causes and leads to cell death (osteonecrosis). Significant necrosis leads to the total collapse of the overlying articular cartilage of the femoral head secondary to the underlying necrotic subchondral bone failure. This occurs before revascularization and regeneration of the necrotic bone can occur due to loss of the underlying structural rigidity of the affected bone as osteoclasts resorb it. The end result of this process is early osteoarthritis (OA) of the hip. The patient will often require a total hip replacement as the osteoarthritis progresses. AVN occurs in 15% to 50% of cases of femoral neck and head fractures and 10% to 25% of hip dislocations. Internal fixation is generally preferred in young patients to save the natural femoral head after a fracture. In contrast, in old...

  Mainly advanced and Metastatic Squamous cell esophageal carcinoma are diagnosed in the later stage of the disease, resulting from extensive surgical resection more or less associated with perioperative chemotherapy or neoadjuvant radiochemotherapy. Advanced and metastatic Squamous cell esophageal carcinoma becomes apparent with tumor growth, inability to swallow solids is followed by difficulty swallowing ground food and, finally, liquids. The advanced disease presents as polypoid intraluminal masses and loss of esophageal distensibility in the presence or absence of luminal narrowing. Progressive dysphagia is the most common complaint in most patients (90%) with greater than 50% luminal occlusion or where the luminal diameter is less than 13 mm. Squamous cell carcinoma represents 90% of EC in the world. It develops from squamous epithelium, from hyperplasia to dysplasia to cancer. At the molecular level, it is linked to particular TP53, NOTCH, and MTOR gene deregulation. Early-s...

  Melanoma arises from the melanocytes of cutaneous or pigmented tissues such as the eyes or intestines. Melanoma, when malignant, has a marked propensity to metastasize to the brain. About 90% of melanomas are diagnosed as primary tumors without any evidence of metastasis. Australia has the highest melanoma incidence rate; New Zealand has the highest melanoma mortality rate. The major oncogenic mutations associated with melanoma are BRAF, NRAS, c-KIT, PTEN, and GNAQ/GNA11. BRAF is the most widely studied mutation; prevalence in primary melanoma ranges from 50% to 60%. Around 5% to 12% of the patients with melanoma have a family history of CMM in one or more first-degree relatives.   So far, more than 75 somatic mutations in the BRAF gene have been identified in melanoma, and all mutations at V600 in exon 15 constitutively activate BRAF. The mutations are either in the activating segment in exon 15 or the glycine-rich loop (P-loop) in exon 11 of the kinase domain of the ...