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Article: The Development of Diabetes and Diabetic Ketoacidosis Following Immunotherapy Treatment: A Systematic Review of Case Reports.

Nagy, Stephanie / Demory Beckler, Michelle / Hussein, Atif / Kesselman, Marc M

2024 Volume 16, Issue 4, Page(s) e57894

Abstract: As cancer continues to be the leading cause of death worldwide, additional therapeutic options other than traditional platinum-based chemotherapy have become available that target tumor cells in innovative ways. Immunotherapies (e.g., immune checkpoint ... ...

Abstract	As cancer continues to be the leading cause of death worldwide, additional therapeutic options other than traditional platinum-based chemotherapy have become available that target tumor cells in innovative ways. Immunotherapies (e.g., immune checkpoint inhibitors (ICI)) ramp up the immune system to target cancer cells, providing patients with more personalized and tumor cell-specific treatment options. This new age oncological treatment option has been found to provide a more meaningful and stronger alternative to traditional chemotherapy, resulting in longer periods of remission and milder side effects. However, because ICI heightens the immune system, resultant autoimmune conditions can occur. One of the most recently shown adverse effects of ICI are extreme hyperglycemia (i.e., type 1 diabetes) and diabetic ketoacidosis (DKA). To determine the incidence of immunotherapy-induced diabetes, a systematic literature review was performed using CINHAL, EBSCO, MEDLINE, and Web of Science. A total of 403 articles were initially screened, with a final 28 case reports included. The results show that checkpoint inhibitors were found to be most commonly associated with new-onset diabetes as opposed to traditional chemotherapy. Additionally, 41% of patients developed autoimmune diabetes and DKA after being placed on a single therapy of pembrolizumab (targets PD-1: programmed cell death protein 1). However, the pathological process underlying the development of endocrinopathies after treatment with ICI continues to be under investigation.
Language	English
Publishing date	2024-04-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.57894
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Correction: Surgical Versus Non-Surgical Treatments for the Knee: Which Is More Effective?

Surakanti, Amulya / Demory Beckler, Michelle / Kesselman, Marc M

Cureus

2023 Volume 15, Issue 7, Page(s) c129

Abstract: This corrects the article DOI: 10.7759/cureus.34860.]. ...

Abstract	[This corrects the article DOI: 10.7759/cureus.34860.].
Language	English
Publishing date	2023-07-14
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.c129
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Surgical Versus Non-Surgical Treatments for the Knee: Which Is More Effective?

Surakanti, Amulya / Demory Beckler, Michelle / Kesselman, Marc M

Cureus

2023 Volume 15, Issue 2, Page(s) e34860

Abstract: Osteoarthritis is a degenerative joint disease that is extremely prevalent in society. It affects more than 25% of Americans above the age of 18 years. According to July 2020 publication by the Centers for Disease Control (CDC), osteoarthritis affects ... ...

Abstract	Osteoarthritis is a degenerative joint disease that is extremely prevalent in society. It affects more than 25% of Americans above the age of 18 years. According to July 2020 publication by the Centers for Disease Control (CDC), osteoarthritis affects approximately 325 million Americans. One of the organs that is most affected by osteoarthritis is the knee. Over the years, we have developed non-surgical treatments, such as physical therapy (PT) and injections, and surgical treatments, such as total knee arthroplasty (TKA) and arthroscopic lavage, for knee osteoarthritis (KOA). If a patient fails with non-surgical options, which are tried first to avoid the risks of surgery, the patient may be considered for knee surgery. This article will investigate the different non-surgical options and TKA as treatment options for KOA based on current literature. The goal of this paper is to be a comprehensive resource for physicians and patients with KOA to make an informed decision. A systematic literature search was conducted using PubMed. The search terms were based on the type of treatments for KOA. To find articles that compared TKA to non-surgical treatments, the terms included "osteoarthritis", "total knee", and "non-surgical treatments," in combination. For other non-surgical treatments such as PT, weight reduction, and injections, a combination of the treatment, "osteoarthritis", and "knee" were included in the search. For the tier 1 process, any randomized controlled trials were included. Any case reports, observational studies, and cross-sectional studies were eliminated from the search. For the tier 2 review process, any articles that did not have relevance to the topic were eliminated after reading the abstracts of the articles. After review of the literature, the data seem to suggest that TKA with 12 weeks of non-surgical treatment improved pain and functionality of the knee more than just 12 weeks of non-surgical treatment when followed up at 12 and 24 months. However, non-surgical treatment before TKA delays the need for surgery. Supervised PT, either in a group or individual format, has been shown to delay TKA in 95% patients in the group that received PT at the end of one year. In addition, weight reduction has been shown as an effective strategy to improve pain and functionality in KOA patients, which decreases the urgency for surgery. Furthermore, platelet-rich plasma (PRP) injections have been shown to have long-term symptomatic relief for KOA compared to hyaluronic acid (HA) and corticosteroid injections. However, HA and corticosteroid injections are beneficial in treating KOA more than receiving no treatment. Physicians often have difficulty deciding whether to pursue conservative or surgical treatment for patients with KOA. The non-surgical treatments explored in this review - PT, injections, and weight reduction - can provide symptomatic relief and, in some cases, delay the need for surgical intervention. However, based on some randomized clinical trials mentioned in the article, patients receiving TKA have more relief, better quality of life, and improved functionality compared to non-surgical therapy. However, a critical review of this important field of debate shows that there are limited randomized controlled studies comparing the effectiveness of TKA and non-surgical treatments for KOA. We believe that this controversial topic needs further clinical investigation.
Language	English
Publishing date	2023-02-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.34860
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The Role of Clock Genes in Maintaining Circadian Rhythm and Rheumatoid Arthritis Pathophysiology.

Kulkarni, Arathi / Demory-Beckler, Michelle / Kesselman, Marc M

Cureus

2023 Volume 15, Issue 5, Page(s) e39104

Abstract: Rheumatoid arthritis (RA) is a chronic, progressive autoimmune condition that affects up to 1% of the world population and symmetrically affects the joints leading to joint stiffness and decreased mobility. RA patients present with increased pain and ... ...

Abstract	Rheumatoid arthritis (RA) is a chronic, progressive autoimmune condition that affects up to 1% of the world population and symmetrically affects the joints leading to joint stiffness and decreased mobility. RA patients present with increased pain and chronic inflammation within their joint spaces, which researchers have linked to poorer sleep patterns, including difficulty falling asleep and non-restorative sleep. As such, identifying mediators of poor sleep quality among RA patients may improve their long-term quality of life. More recently, researchers identified an association between chronic inflammation in RA patients and their circadian rhythm. Altered circadian rhythms negatively impact the hypothalamic-pituitary-adrenal (HPA) axis and lead to altered cortisol release. Cortisol has shown to have a strong anti-inflammatory effect; when dysregulated, it may lead to increased pain experienced in RA patients. This literature review aims to provide insight into how chronic inflammation tied to RA pathophysiology may affect clock genes that are involved in maintaining the circadian rhythm. Specifically, this review focused on four common clock genes found dysregulated in RA patients: circadian locomotor output cycles kaput (
Language	English
Publishing date	2023-05-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.39104
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Exploring the Relationship of SARS-CoV-2 and Uric Acid Levels With a Focus on Gout Patients: A Scoping Review.

Patel, Hemangi / Basra, Mahi / Muralidhar, Rohit / Demory Beckler, Michelle / Kesselman, Marc M

Cureus

2024 Volume 16, Issue 3, Page(s) e57138

Abstract: Rheumatic diseases are a group of conditions including arthritis and various other conditions that can lead to chronic inflammation within the musculoskeletal system, which can have negative effects on soft tissues, bones, muscles, joints, and connective ...

Abstract	Rheumatic diseases are a group of conditions including arthritis and various other conditions that can lead to chronic inflammation within the musculoskeletal system, which can have negative effects on soft tissues, bones, muscles, joints, and connective tissue. One form of arthritis is gout, which is an inflammatory condition in which urate acid crystals build up in joints. Gout is associated with joint swelling, pain, redness, and joint mobility issues. Early diagnosis and treatment are essential to prevent joint degradation and other adverse complications. The condition has been shown to increase the incidence of diseases outside the musculoskeletal system, including the renal and cardiovascular systems. Comorbid conditions associated with gout include but are not limited to type 2 diabetes mellitus (T2DM), hypertension, hyperlipidemia, chronic kidney disease, cardiovascular disease, and heart failure. This systematic review aims to provide insight into the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, uric acid levels, and gout.
Language	English
Publishing date	2024-03-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.57138
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The Overlap of Diabetes and Osteoarthritis in American Populations.

Nadella, Harshita / Bloom, Allan W / Demory Beckler, Michelle / Kesselman, Marc M

Cureus

2023 Volume 15, Issue 4, Page(s) e38287

Abstract: Diabetes mellitus, a condition in which the body's ability to produce insulin is impaired, and osteoarthritis (OA), a painful degeneration of joint cartilage, are both serious conditions that affect millions of people in the United States (U.S.). ... ...

Abstract	Diabetes mellitus, a condition in which the body's ability to produce insulin is impaired, and osteoarthritis (OA), a painful degeneration of joint cartilage, are both serious conditions that affect millions of people in the United States (U.S.). Osteoarthritis is a chronic degenerative condition of the joint cartilage, affecting mainly the older population. The purpose of this paper is to find a connection, if any, between diabetes and osteoarthritis and if either condition can predispose an individual to the other. Not only can this review help to explain the co-existence of these two diseases, but it can also be used to look into a cure for patients in the future. After preliminary searches were done on PubMed, results were narrowed using specific keywords and similar risk factors among the two diseases. It was found that these two conditions are actually interrelated due to oxidative stress and pro-inflammatory cytokines. Seeing the high risk of developing one of these conditions and that obesity, one of the biggest risk factors for both diabetes and osteoarthritis, is at an all-time high in this country, a possible connection between the two of these diseases is very prevalent to look into. This information can be used to help correlate not only a better-targeted treatment but also lead to future research into why obesity is one of the biggest risk factors for both conditions.
Language	English
Publishing date	2023-04-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.38287
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The Impact of Modern Dietary Practices on Cancer Risk and Progression: A Systematic Review.

Nagy, Stephanie / Petrosky, Stephanie N / Demory Beckler, Michelle / Kesselman, Marc M

Cureus

2023 Volume 15, Issue 10, Page(s) e46639

Abstract: Cancer is a leading cause of mortality around the world, despite continued advancements in the management of cancer. Recent research efforts have shifted to evaluating the role that modifiable risk factors play in cancer risk and development, as diet and ...

Abstract	Cancer is a leading cause of mortality around the world, despite continued advancements in the management of cancer. Recent research efforts have shifted to evaluating the role that modifiable risk factors play in cancer risk and development, as diet and nutrition have been found to play a significant role in the onset and progression of cancer. As a result, there has been an increasing focus on the impact of dietary modifications on preventing the onset, progression, and reoccurrence of cancer. In this systematic review, data were collected on three common diets, the Mediterranean diet (MD), ketogenic diet (KD), and plant-based diet, to gain insight into the application of these three dietary modification approaches for risk prevention and limitation of cancer burden. Initially, 4,397 articles were identified from three databases (Ovid, Web of Science, and CINHAL). After removing studies based on the exclusion criteria, only 23 studies were eligible to be included in the systematic review of which 15 evaluated the MD, four assessed the ketogenic diet, and four evaluated the plant-based diet. Each article was considered for its methods, procedures, and findings. The findings indicate that dietary interventions may effectively reduce the odds of cancer development and the advancement of diagnosed cancers. With the introduction of the MD, KD, and plant-based diets, significant improvements in lowering cancer development, recurrence-free status, and limiting tumor growth were noted across numerous cancer types. Currently, the MD has been extensively studied in the literature, and amongst the widest variety of cancer types. Additional information and evaluation are required on the ketogenic and plant-based diets to fully understand their impact on the cancer burden across a wider subset of cancers. Clinicians should evaluate and recommend nutritional adaptations to their patients to limit the development of specific cancers and as an adjunctive therapy to traditional pharmacological treatment options for patients with diagnosed cancers.
Language	English
Publishing date	2023-10-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.46639
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Paradoxical Tumor Necrosis Factor-Alpha (TNF-α) Inhibitor-Induced Psoriasis: A Systematic Review of Pathogenesis, Clinical Presentation, and Treatment.

Chokshi, Aditi / Demory Beckler, Michelle / Laloo, Anita / Kesselman, Marc M

Cureus

2023 Volume 15, Issue 8, Page(s) e42791

Abstract: Tumor necrosis factor-alpha (TNF-α) inhibitors have been shown to be well tolerated among patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis. Meanwhile, more recently, clinical practice and research efforts have uncovered ... ...

Abstract	Tumor necrosis factor-alpha (TNF-α) inhibitors have been shown to be well tolerated among patients with rheumatoid arthritis, inflammatory bowel disease, and psoriasis. Meanwhile, more recently, clinical practice and research efforts have uncovered increasing cases of psoriatic lesion development tied to initiating treatment with a TNF-α inhibitor. The underlying mechanisms associated with this occurrence have yet to be fully elucidated. A review and analysis of cases of paradoxical psoriasis currently published in the literature is warranted. In addition, exploring possible mechanisms of action and potential treatment options associated with favorable outcomes is much needed. A systematic literature review was performed utilizing PubMed and Google Scholar databases (1992-present), in which 106 cases of paradoxical psoriasis were reviewed. The most common morphology developed was plaque psoriasis vulgaris. There was a female predominance (61.3%), and the most common underlying autoimmune disease was rheumatoid arthritis (45.3%). In addition, the most commonly associated drug with the onset of psoriatic lesions was infliximab (62.3%). Furthermore, the findings suggest that the most well-supported mechanism of action involves the uncontrolled release of interferon-alpha (IFN-α) from plasmacytoid dendritic cells (pDCs) after TNF-α inhibition. While TNF-α inhibitors have been shown to have great benefits to patients with rheumatologic diseases, cases of paradoxical psoriasis demonstrate the importance of close monitoring of patients on TNF-α inhibitors to allow for early recognition, treatment, and potentially change to a different mechanism of action of the medication used to prevent further progression of the inflammatory lesions.
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.42791
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Targeting the NOD-, LRR- and Pyrin Domain-Containing Protein 3 (NLRP3) Inflammasome in Psoriasis and Fatigue.

Seguro, Charmaine Kue / Demory Beckler, Michelle / Kesselman, Marc M

Cureus

2022 Volume 14, Issue 5, Page(s) e24704

Abstract: Inflammasomes are intracellular, multi-protein signaling complexes of the innate immune system that activate and control inflammatory responses in nucleated cells. Among these inflammasomes, the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) ... ...

Abstract	Inflammasomes are intracellular, multi-protein signaling complexes of the innate immune system that activate and control inflammatory responses in nucleated cells. Among these inflammasomes, the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome, a cytosolic sensor that modulates inflammatory responses in nucleated cells upon detection of various danger signals and microbial motifs, has been shown to a play a role in a wide range of pathologies and associated symptomatologies, including psoriasis and associated fatigue. Activation of the NLRP3 inflammasome can lead to caspase-1-dependent release of inflammatory cytokines, which potentially act on surrounding cells and may contribute to symptoms of fatigue. In this review, we will present recent developments in NLRP3 inflammasome research as it relates to psoriasis and fatigue, with a focus on the intracellular signaling pathways governing NLRP3 inflammasome regulation and promising pharmacological therapeutics that inhibit NLRP3 inflammasomal pathways.
Language	English
Publishing date	2022-05-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.24704
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Underlying Immune Mechanisms Involved in Cow's Milk-Induced Hypersensitivity Reactions Manifesting as Atopic Dermatitis.

Weimer, Derek S / Demory Beckler, Michelle

Cureus

2022 Volume 14, Issue 8, Page(s) e27604

Abstract: Of the many symptoms associated with cow's milk allergy (CMA), many populations face the burden of the appearance or worsening of atopic dermatitis (AD) when consuming milk products. Due to the prevalence and possible severity of symptoms, it is ... ...

Abstract	Of the many symptoms associated with cow's milk allergy (CMA), many populations face the burden of the appearance or worsening of atopic dermatitis (AD) when consuming milk products. Due to the prevalence and possible severity of symptoms, it is important to understand the underlying immune mechanisms involved in such reactions. Hypersensitivity reactions are exaggerated immune responses to often benign antigens, many times resulting in a cascade of pro-inflammatory processes. Of the four major types, type I and IV are of most relevance when considering atopic dermatitis worsened by cow's milk. Considered a "true allergy," type I (immediate) hypersensitivity reactions occur within hours after secondary exposure to an allergen and are primarily driven by antibodies and humoral immune responses. On the contrary, type IV (delayed) hypersensitivity reactions are driven by cell-mediated responses involving T-cell activation. Due to the array of symptoms induced by these complex reactions, it is imperative to diagnose early and treat appropriately. In this literature review, we aim to highlight the primary underlying immune contributors to hypersensitivity reactions, discuss AD as a manifestation of hypersensitivity reactions to cow's milk, and consider current and future treatment options for combatting hypersensitivities manifesting as AD.
Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.27604
Database	MEDical Literature Analysis and Retrieval System OnLINE

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